I had an interesting conversation today with a Director of IT Security from a large healthcare provider in Delaware who is a customer of mine.
The conversation was mostly to do with what his daily responsibilities were, how he balanced competing priorities and to gain a better understanding of his particular challenges.
I went into this meeting with my only desire to better understand him as a person and see how I could be of better value to him as my customer.
I did not expect to come away from the conversation with real world cases of how culture within an organization can change over time, but I have found when you keep your ears open it is surprising what people will say.
Some of you may have experience with healthcare providers, either as a patient or perhaps in a business relationship. I am sure that one thing we can all agree upon is that as a rule they can be slow to adopt, adapt and mature.
This may be hardwired into the DNA of the organization. I know that when I break my leg a doctor will put a cast in it because that has been proven to work through millions of previous experiences.
This can be the desired outcome versus the doctor that decides to try a different remedy for every broken leg.
As I was speaking with my customer he said one thing that struck me. He said, “slow is smooth, smooth is fast.”
He was saying this in reference to his desire to shape the culture to be more security conscience. However, he understood that if radical changes were made overnight he would lose the support of the organization. Instead he was implementing incremental changes over time to affect change.
Isn’t this the desired outcome?
As I think through this, there are times when radical change is needed, but typically it’s at the personal level that it is achieved.
Obvious examples being taking up exercise, limiting the amount of alcohol or taking up a new routine.
Try and push that on your friends or family overnight and good luck!
It takes time and buy-in from the group to effect lasting change.
That leaves us with a question that I do not yet have the answer to.
MAP is also the great excuse, the adult version of the “because I said so” people use on their kids.
How often, when asked why you do X, have you responded “because that’s the way I am.”
Organizations have two versions, “not-invented-here” and “we’ve always done it that way.”
Whether individual or company, both use them to avoid innovation, change and disturbing their comfort zone.
But at what cost?
Marshall Goldsmith calls it “an excessive need to be me“ and tells the story of a CEO who was lauded in other areas, but refused to provide positive feedback because it wasn’t him and would, therefore, be phony.
The example isn’t as extreme as you might think. I’ve talked with many executives, managers and workers who use authenticity as their reason not to change their MAP.
And because authenticity is hot, it’s the perfect excuse for not tackling the root causes of whatever needs to change, although, as with most excuses, it doesn’t hold up well to the light of honest, intelligent analysis.
But what do you analyze; how do you know what to change?
Take feedback from your colleagues, team and customers; then take a hard look whenever the answer to “Why?” is some variation of the reasons mentioned earlier.
Then think it through; ask yourself if there is a real, rational reason to stay that way or if it’s something that would be better to change,
And remember, whether individual or company, the most powerful reason for changing MAP is that doing so pays off handsomely, as the CEO in Marshall’s story learned.
Changing culture doesn’t happen overnight and takes a lot of damn hard work.
But it can be done.
And for CEOs willing to take the time and do the work, the payoff is ginormous to the 10th power and goes well beyond money — for the company, the employees, stakeholders and last, but certainly not least, for themselves.
What needs to change is the culture of not only insurance companies, but medical service providers (doctors, labs, testing, hospitals, etc.), other various and sundry vendors within the ecosystem, not to mention the government in the form of Medicare and Medicaid.
When you look at the deeply entrenched interests on that list the possibility of anything actually happening in the near-term seems remote, if at all.
Not even the proverbial 500 pound gorilla, think Google or Facebook, has the clout to even dent that crowd.
But what about Aetna Insurance under CEO Mark Bertolini, a 1000 pound gorilla and long-time global player in healthcare that has the clout, since it insures two thirds of the Fortune 100 and a great number of the 500?
Aetna is taking a three prong approach that includes, paying for positive outcomes, as opposed to fees for services; changing corporate health offerings in order to tap into positive consumer behavior and eating its own dog food — as every good startup does.
The big question is whether Aetna will walk its talk.
According to Kentaro Toyama, the W.K. Kellogg Associate Professor of Community Information at the University of Michigan School of Information and self-described “recovering technoholic,” technology isn’t the panacea it’s cracked up to be.
“Technology works best in organizations that are run well to begin with. (…) The technology industry itself has perpetuated the idea that technology will solve the world’s problems. (…) Everyone wants to believe the work they do is good for society. But a lot of people in the industry have drunk a little too much of their own marketing Kool-Aid.”
What is often ignored is that people are a necessary ingredient for the Kool-Aid to actually work.
The tech eco-system forgets a lesson driven home by Bill Gates in the 1995 book The Road Ahead.
“The first rule of any technology used in a business is that automation applied to an efficient operation will magnify the efficiency. The second is that automation applied to an inefficient operation will magnify the inefficiency.”
Aetna Insurance found this out when they first equipped their claims processors with their own terminals connected to the mainframe (before the advent of personal computers).
The effort was considered ground-breaking and was touted as a way to streamline the claims process.
It failed miserably, because the process itself wasn’t redesigned.
In short, claims had multiple steps with approval required at each. Because the process stayed the same, i.e., claims stalled in electronic form when someone in the approval process was on jury duty or out sick just as they did in the paper version.
Once people redesigned the process the desired efficiencies were reaped well beyond expectations.
Steve Blank wrote a great post about changing culture in larger organizations. It’s a must-read for anyone in business, government or non-profit who is looking to juice innovation in their organization.
Blank agrees that there are four components to culture.
Two McKinsey consultants, Terry Deal and Arthur Kennedy wrote a book called Corporate Cultures: The Rites and Rituals of Corporate Life. In it they pointed that every company has a culture – and that culture was shorthand for “the way we do things at our company.” Company culture has four essential ingredients:
Values/beliefs – set the philosophy for everything a company does, essentially what it stands for
Stories/myths – stories are about how founders/employees get over obstacles, win new orders…
Heroes – what gets rewarded and celebrated, how do you become a hero in the organization?
Rituals – what and how does a company celebrate?
He goes on to explain what needs to be done for “innovation to happen by design not by exception.”
In reality it should be a subset of values/beliefs, but it is rarely thought about by bosses — they either do it or do the opposite automatically.
It can be summed up in four words, don’t kill the messenger—Pete Carroll, coach of the Seattle Seahawks, is a master of this mindset.
To be truly innovative means trying new stuff and a part of trying new stuff is accepting that it won’t always work.
Corporate culture in general and many bosses individually can’t seem to wrap their minds around the idea that some things will fail — it’s the dark side of the ‘but me mindset’ at work.
What they, and anybody setting out to change culture and encourage innovation, need to understand is that it only takes killing the messenger, i.e., responding negatively to the person who brings bad news, once to negate whatever progress had been made and put the effort back to square one.