OrgVitality Chosen to Assist American Board of Internal Medicine to Improve Physician Evaluations

The American Board of Internal Medicine (ABIM) has become increasingly aware of important gaps in their evaluations of physicians.  OrgVitality Vice President Dr. David W. Bracken has been invited by ABIM to help address those shortcomings and bring a unique perspective to the issue by participating in a Multi-Source Feedback Expert Panel Meeting as an authority in the field. In addition to participating in panel and roundtable discussions, Dr. Bracken has been asked to provide a presentation that summarizes best practices in multisource feedback outside of the medical field that may have implications for physician evaluations and certification. Dr. Bracken is the senior editor and author of the Handbook for Multi-Source Feedback (2001, Jossey-Bass).

The American Board of Internal Medicine (ABIM) is an evaluation organization. Providing practicing physicians with effective performance-based assessment methods has the potential to strengthen certifying boards’ ability to meaningfully assess performance in practice. Multi-source feedback as a unique approach has the potential to assess key competencies such as interpersonal skills and communication, professionalism, teamwork, stewardship and care coordination.

With this in mind, ABIM’s research team has convened an international group of experts in assessment and multi-source feedback, representatives from ABMS Member Boards, and others from fields outside of medicine to better understand how and why multi-source feedback approaches and tools might be incorporated in a comprehensive, performance-based assessment program.

The ABIM Multi-Source Feedback Expert Panel Meeting will be held in February 2012, at ABIM headquarters in Philadelphia.

About OrgVitality, LLC:

OrgVitality is a management consulting firm focused on helping individuals and organizations thrive in today’s turbulent environment. We help organizations make sustainable improvements in their operations and offerings, increasing their Vitality and enabling them to excel in their unique organizational strategies. The firm consists of highly experienced and respected professionals with technical expertise, consulting and research backgrounds in Industrial Organizational Psychology and Human Resources with an average of 15+ years of experience in their respective fields. OrgVitality, headquartered in Westchester, NY, has operations in New York, San Francisco, Atlanta, Tel Aviv, Spokane, Raleigh Durham and Orlando.

OrgVitality’s services include Employee Opinion/Engagement Surveys, Leadership Competency Models, 360 Assessments, Exit Surveys, Coaching & Executive Assistance, Succession Planning, Performance Management, HR Metrics & Strategy, Customer Surveys (Internal & External), Employee Assessment & Selection, and Leadership Training & Development. For more information, please visit www.orgvitality.com, email contactus@orgvitality or call (914) 747-7736.

 

Recognition

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“Appreciation is a wonderful thing. It makes what is excellent in others belong to us as well.”

Voltaire

One of the basic fundamentals in achieving high performance from individuals is to provide them recognition for a job well done, sincere meaningful recognition. Being given recognition becomes part of the equity equation as people consider whether they are being treated fairly by an organization. Recognition can consist of psychological recognition, monetary rewards, advancement, development opportunities as well as a host of other possibilities.

There are two classes of rewards and recognition – those that can be tied to performance, such as merit increases, and those that should be independent of performance – those that are a standard that should be made equally available to all.  For instance, if you were running a mining operation you would not hand out safety equipment as recognition for good performance, rather all miners would be given equal access to the safety equipment available.  The ability to operate safely on the job and access to safety equipment is independent of individual performance.

I had one client that had tied recognition, the score you received on your performance appraisal, to the health care benefits you received. If you scored highly on your performance appraisal and got sick you were flown to Singapore where you received the best medical treatment available. If you did not score highly on your performance appraisal local health care was made available, which was definitely below world-class status. After a few conversations with the management of this organization, I convinced them that these 2 elements should not be tied together.

This was a clear example that recognition on the job (in this case the ratings on your performance appraisal) could have an impact on your life expectancy. But there has come to light additional new evidence. Matthew D. Rablen and Adrew J. Oswald of the University of Warwick, found that winning a Nobel Prize can add as much as 2 years to your life. When candidates are nominated for a Nobel Prize they do not know it, as the lists of nominees are not released for fifty years after the Prize is awarded. This sets up a situation where the winners (who know they won) can be compared against those nominated (who don’t know that they were nominated). Those who won and received the associated recognition lived longer. “The only possible explanation is that the enhanced status conferred by a Nobel somehow improves a person’s health. Walking across the platform in Stockholm does wonders” said Andrew Oswald, one of the authors of the study. Remember that the nominees are no slouches, they are all very well thought of in their respective fields, but the status associated with the Nobel, somehow provides a little bit extra.

Given that many organizations are keen on improving the health of the workforce to reduce health insurance rates and to raise productivity, I wonder if they have ever viewed providing recognition as a health related practice. Also importantly can organizations make their rewards and recognition confer that little something extra? Could the budgets associated with recognition be offset against health insurance increases? Or on the flip side could organizations that provide no recognition be blamed for ill health or hastening the death of an employee?  The human brain’s impact on internal bodily processes is simply not to be underestimated.

Sometimes recognition comes from unexpected sources. Abraham Lincoln when faced with many rivals within his own party for the position of President decided that the best place for them was within his cabinet. By keeping his rivals close to him, he could keep an eye on them but he was also telling them something. He was providing them recognition of their abilities and saying that he wanted them working with him, because he valued their input, rather then being at odds with them.

There is a myth that exists around brilliant people (maybe even just smart people) and recognition. It is that these people are intrinsically motivated and that means that they do not need or desire recognition for a job well done. Doing good work by itself is rewarding enough. (I get this feeling that this myth was developed by people who feel somewhat intimidated by really smart people). While there may be a few people like that out there, my experience is that the vast majority, while they may be intrinsically motivated, like nothing more than a pat on the back and other recognition for doing good work. They, like us, put their pants on one leg at a time in the morning (assuming you are wearing pants) and while they may really like their independence, they really like people recognizing their contributions as well.

Recognition is one of those fundamentals that cut across organizations, cultures, occupations, geographies, generations and genders. It works and has an impact on your work environment as well as in your personal space. The next time you have an opportunity, and want to tell someone that they did a good job and you appreciate them, don’t hold it in, let it out and see what kind of benefits you can spread.

© 2010 by OrgVitality, Jeffrey M. Saltzman. All rights reserved.

Visit OV: www.orgvitality.com

Downstream Wash & Dry

There is an old fable that goes something like this: A father was giving his son some advice. The father asked the son what skills he would like to learn; how he would like to earn a living. The son said that he would like to learn to wash clothes in the river. Washing clothes being a good honest trade, he sent his son down to the river to learn and told him “Become the best clothes washer you could possibly be”. The son worked very hard and opened a small clothes washing business called “Downstream Wash & Dry”, and soon his work became known for producing the cleanest clothes possible and he prospered. People stood in line in for hours to get their clothes washed by the agreeable washerman. A few years later a paper mill opened upstream from the son’s business, fouling the river water. No one wanted their clothes washed downstream of the paper mill. What was the son to do? He checked the village records and found that the paper mill was operating legitimately and had all the necessary permits. He then checked with the landowners above the paper mill to see if he could purchase any land close enough to the village so he could successfully relocate his business and found that all the nearby land had been bought up by a company called “Upstream Wash & Dry”, which had just opened a franchise in town. The competition, upon seeing the success of Downstream, had been paying close attention to the changing environment, waiting for an opportunity to clean up and grab market share. The moral of the story: Simply being very good at something can become irrelevant if your operating assumptions don’t keep up with the times. This fable has a happy ending (as fables should), for the father was watching over his son’s business and had already invested in “Downstream Water Filters”, whose products allowed the son’s business to continue.    

If the first time you are thinking about how to manage your business or your employees through a down business cycle is when you have already entered a down business cycle, do yourself a favor—turn off the lights, lock the door and go home. The time to think about these things, like so many other things in life, is prior to when you actually need them. No one, at least not many, would think about retirement for the first time on the very day they were to retire, and no one should be thinking about how to manage in a down cycle for the first time upon the realization that they are in a down cycle. “Now let’s see, where did I put that magic button?” Having said that, if we assume that some prudent steps were taken prior to the down cycle, there are some things that can help ease an organization through a downturn.

How do you motivate employees to do their best at work during a downturn, especially when the future is uncertain and layoffs are possible?

I would answer that question with another. How did you motivate employees prior to the downturn? While there may be some nuances to operating in a downturn, good business practices are still good business practices. If you have built a reputation for open and honest communication, that will stand you in good stead with your employees and during a down cycle you want to increase the frequency and amount of communication even when the news is bad. During times of turmoil people’s desire for communication increases exponentially, so while the natural tendency may be to withhold bad news, it is better to increase the information flow. A lack of information will cause people to fill in the blanks—and they will generally fill in the blanks with an imagination that creates worse scenarios than the reality.

But communications is simply process. What should you be communicating about? Message. Now is the time to unveil the plans you had developed during the good times and let people know how you will cope with the bad. What are the timeless principles by which the company will continue to operate regardless of the environment? What will you do? How will you treat people? How will you cope with lower business volumes and potentially shrinking market share? Performance. What will the organization do to enable people to get their jobs done and done well? What new strategies will be put into place, what new products that are more attractive in a down market? Future. What are the compelling reasons why someone should stick around and help the organization make it through a down cycle? What is in it for the individual? 

What can an organization do to show its top talent how crucial they are and prevent them from jumping ship?

If all your talent is not crucial to your success that means you have not been dealing with issues that you should have dealt with prior to the downturn. Using the downturn as an excuse to deal with performance issues, under the banner of “downsizing”, will be transparently seen through and is potentially alienating to other employees. In other words, the organization was looking for an excuse rather than dealing with issues on an ongoing basis. People who are able to help reinvent the organization, its products and services and its ways of operating will be crucial to the long-term success of the organization and should be rewarded appropriately. The traditional rewards such as money and opportunity are traditional because they have been found to work.  

If your company is forced to lay off people, how do you then reassure and engage those that are left?

Alternatives to the layoff should be considered first. Can other operating costs be cut? Will some take an early retirement if it is offered? Can an across-the-board pay cut be implemented so that everyone can stay employed? Are some willing to go to a part-time schedule? One of the privileges of being in management is that they should take the lead in suffering during a down cycle. They should be the first to take a pay cut and they should be cut the deepest. If a layoff does happen management should also be laid off in equal percent to the non-management employees, rather than being viewed as a protected group.  Those companies that can retain their talent though, assuming that they have been dealing with performance issues on an ongoing basis, will be better positioned to flourish in the recovery. If a layoff happens, it happens as a last resort, not a first choice. It should happen all at once and not in a slow drip kind of fashion. Once completed, the staff should be told that the downsizing is finished as long as market conditions are stable. Based on this approach people will recognize that the company operates in a manner that tries to protect their employment to the extent possible and that when pain is to be suffered it is suffered in a fair and equitable fashion and that will provide reassurance.

Feedback

“Performance Review May Have Sparked NASA Shooting” screams a CNN headline. In Houston, the local police were trying to determine a motive for why a NASA contractor   fatally shot his boss and took another employee hostage before killing himself at the Johnson Space Center. It seems that this boss sent him an email performance review that was critical of his performance – performance review by email? NASA has said that they will review security procedures. I could not help but add in my mind “what about performance appraisal procedures”? Shouldn’t those be reviewed as well? It seems like a classic case of ignoring the underlying issue. If it proves out that the performance appraisal was the key, tightening security only gives the next person who wants to smuggle in a handgun a slightly greater challenge to overcome, rather than addressing the root cause.

Not too long ago on an employee survey in which attitudinal responses could be matched up to people’s performance appraisal rating, what we saw is that the largest gap between the highest rated performers and the lowest rated performers was “feeling valued by the organization”. Receiving a poor performance appraisal did not affect people’s intention to stay or leave; their feelings about the appraisal in helping them improve their performance, or a host of other potential actions. The one thing it did affect in this organization was the self-report by poor performers that they did not feel valued. So if the goal of this performance appraisal system was to make a certain group of employees feel less valued by the organization, it was working. If the goal was something else it was not.

In one manufacturing organization with a union, the goal (not officially stated) of the performance appraisal system was simply to document poor performance – “write em up”, was a commonly used expression. The thinking being that the organization needed to build a case in order to withstand the inevitable challenge from the union should they need to dismiss a person.

Meanwhile at the Russian News Service which controls a number of radio broadcast stations in Russia, good news is becoming official policy. The New York Times reports that the managers of the news service had implemented a policy that at least 50 percent of the news coverage on or about Russia must be positive. These apparent Kremlin allies also stated that opposition leaders could not be mentioned and the United States was to be portrayed as an enemy. “When we talk of death, violence or poverty, for example, this is not positive,” said one editor at the station. “If the stock market is up, that is positive. The weather can also be positive.”

I don’t know about you but I truly do believe in the benefits that a free press brings to society and this kind of manipulation makes my skin crawl. In one fell swoop the Russian News Service has made itself irrelevant and will now begin a decline into oblivion unless it changes course. By putting out 50% positive feedback as a “rule” it’s credibility that it is accurately portraying the news is zero and the Russians as they have done before will turn towards external sources of news to find out what is really happening.

Are people so fragile that they can “snap” upon hearing bad performance appraisal news and are they so easily manipulated that if you feed them a diet of pabulum that they will fall in line with official “policy”, actually believing that all is well due to a steady diet of good news? Of course the reality is likely to be where it usually resides, somewhere in the middle.

I was at a meeting recently where the facilitator put on a demonstration for the 100 or so people in the room. He told everyone to get up, walk around the room and randomly stop and describe to someone an issue you would like to do better upon and then listen to the advice the person had to offer you to improve in that area. Issues were things like “listen more” or “not rush to judgment” or “make more time for family” etc. The person you described your issue to, was supposed to offer one thing to you that you could try to improve in that area, preferably something that had worked for them. Two rules, you could not interrupt your advisor, you had to just listen and second at the end all you were allowed to say to the person giving you advice was “thank you”. At the end of about 20-30 minutes of this we all returned to our seats and were probed about what we thought about this performance improvement session. The results from the attendees were generally very positive. What did they like about this performance appraisal session? It was non-judgmental, it was non-threatening, and it was not done by someone who might have an ulterior motive or an axe to grind with you. So I could listen with an open mind and maybe get something out of the conversation. Maybe. 

How many of us could say that our performance appraisal systems which were designed to help improve the performance of the organization are non-judgmental, non-threatening and done in a truly unbiased fashion. Anyone? It would seem that the systems we have put into place to improve performance are designed in such a fashion as to make that noble goal fairly unlikely. Can it be that performance appraisal and organizational improvement are incompatible? Anyone care to try building one again?

In survey research I have yet to see a performance appraisal system that is well rated by the employees living under that system. Let’s make an assumption that the vast majority of people come to work wanting to do a good job. I think that is a safe assumption by the way. So if we were to create a positive working culture in the organization through tried and true principles and people want to do a good job anyway, maybe we should scrap our performance appraisal systems and develop “organizational improvement systems” and our conversations will be around what the individual can do to help contribute to organizational goals and what skills and abilities they need to develop to help make that happen. What about the 5% of the population that is not doing a good job and need to be eased out of the organization? I believe that their performance issues should not be addressed through the organization improvement system but should be addressed by a separate performance system, a system that would be irrelevant to 95% of the workforce.

What about organizations that tie performance appraisal to merit increase how would that happen if there is no appraisal of someone’s performance? How could we differentiate top performers for will get 4-5% increases from average performers who will get 3%. Do we really need performance appraisal systems to differentiate a 1-2 percentage point difference in salary increases? Seems kind of silly doesn’t it. We should be able to find a different path.

Organizations take a hit from an employee attitude standpoint when they are seen as not doing enough to correct poor employee performance. And in fact they take even more of a hit on that when the organization is a unionized environment. In other words people who are doing a good job and working hard want the others who are around them to be working hard and doing a good job as well. However, designing performance appraisal systems that are needed for 5% of the population, yet are onerous to 95% seems to be a monumental misjudgment.

If our goal is to create superb working environments where people can fulfill their potential and organizations can excel at delivering products and services to their customers we need to roll up our sleeves and get to work, we have a lot of redesigning to do.