HEALTH, PURPOSE & IMPACT

Category: Leadership (page 1 of 3)

Reflections On Fifty Years Of Leadership – from Bill George

I’ve found Bill George’s writings on leadership to be deeply thought provoking – based on his personal experiences, as corporate leader (CEO-Medtronic, EVP-Honeywell), board member, mentor and teacher (Harvard).

The following selected notes are from his article, ‘Reflections On Fifty Years Of Leadership’ (available in the free ebook, Lead True -link shared below). These apply to developing organizations and leaders in all environments.

  • As I reflect on the past half-century, enormous changes have taken place in organizations, their leaders and our expectations of these leaders. Many formerly great organizations have fallen by the wayside, as new ones have sprung up to replace them. Economists often attribute this phenomenon to rapid changes in technology and markets, using phrases like “creative destruction.” I beg to differ with them. If there is one thing of which I am certain, it is that the difference between successful, enduring organizations and those that disappear is the caliber of their leaders – at the top and throughout the organization. Among the most important qualities for leaders, these two stand out: adaptability and courage.
  • All of us will experience great crucibles in our lives from which we can discover what is real for us: our True North. Sometimes in life bad things happen to good people. There is deep learning in these experiences if we take the time to discern their meaning and reframe them to make our lives richer and more meaningful.
  • By choosing leaders for charisma, image and style – subjects often taught by business schools and leadership experts in the 20th century – we were overlooking far better leaders with character, integrity and substance.
  • The defining quality of today’s leaders is their authenticity – their ability to know themselves and discern their True North. Authentic leaders are secure within themselves. They do not need external validation to prop up internal insecurity. Instead, they have worked hard to develop the self-awareness to lead with clarity of purpose, practice their values every day, discern the “sweet spot” where their motivations merge with their strengths, build enduring relationships, and inspire and empower others to rise to the challenge. They know what it means to LEAD TRUE: to have the courage to adapt to any challenge while still being true to themselves.

There are many more valuable notes for reflection and learning throughout the book.  I would highly recommend to read and reflect.

Source: Reflections On Fifty Years Of Leadership, Lead True, Bill George, eBook; http://www.billgeorge.org/wp-content/uploads/2018/09/Bill-George-Lead-True-eBook.pdf

Leadership Development For Smaller Organizations In The New Year – 4 Topics To Consider

Happy New Year to all readers!

Many smaller organizations find it difficult to figure out relevant activities in the area of leadership/management development. Related questions come up frequently and at times, a mistaken perception exists that leadership/management development is only applicable to larger organizations.

If left ignored, this is one area that will hurt any organization in many ways. Worrying symptoms start showing up in different areas for the organization including stakeholder engagement, execution and it becomes difficult to diagnose the real problem as time passes.

Here are four topics under leadership/management development for leaders and HR teams to consider.

  1. Any development effort starts with developing self awareness. Leadership self awareness development can start with understanding oneself deeper through facilitated 360 degree/other feedbacks, personality assessments (like MBTI, Hogan etc.) and follow-up reflections/coaching sessions. These sessions can be facilitated at the individual or team level, or a combination of both for quality reflection and action. Periodic follow-up interventions are invaluable for any development effort. Self aware leaders also recognize coaching opportunities for themselves and their team members toward meaningful results.
  2. A related impactful area to consider focusing on is leadership team development. Many leaders miss the opportunity or don’t take the time to consciously reflect on establishing the building blocks of developing an effective team and co-creating a focused agenda with the team. When teams are not developed consciously and carefully especially at senior levels, it leaves room for potential confusion, conflict and frustration. Even for well established teams, this is an important topic to revisit consistently and not to be taken for granted. Supporting leadership transitions in this context also become highly relevant.
  3. Building a shared understanding of what “leadership“or being a leader in the organization means (leadership constructs) will help clarify expectations. Support can be provided through training programs for first time managers, middle managers and leaders. The more leaders understand what it means to be and is expected from a leader in the organization, the more impactful results organizations can consistently achieve through them.
  4. Building a shared understanding on the organization’s strategy, values and culture is often an important item that loses focus. Many times, the clarity on values and culture stays strong with only the founding or early members. As a result, many people tend to apply their own interpretations which leads the organization’s value system in different directions and dilution over time. Sometimes, there is a need for a discussion on how the culture has evolved or needs to change in the context of business direction. Reinforcing and aligning the organization’s understanding and shared beliefs will ensure stronger cohesion, commitment and execution across the board. This can be facilitated through various well designed OD/HR, engagement and communication initiatives.

If you are a leader or HR professional in a smaller organization considering impactful activities to implement in leadership/management development, these may be some practical and actionable ideas to think about for the new year. It is important to constantly be aware of the paradox of busyness & development.

Best wishes for a Meaningful, Impactful and Successful 2017.

Tojo
Lead-Wise

How Should Leaders Earn Their Premium?

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After years of observing leaders in business and non-profit environments around the world, one point is absolutely clear to me.  Leaders play fundamental roles that determine the success of any organization and impact many lives, directly and indirectly.

If you have any doubt, please check out the business news sections or conduct a quick, direct opinion survey among your experienced connections.  We see this power of leadership manifesting everyday through the news about flourishing or struggling organizations and the resulting massive impact on individual lives and communities, both positively and negatively.

How should leaders earn their premium?

1. By making key decisions/judgments and executing successfully.
This is probably the most important element.  By the nature of key strategic choices, decisions and judgments being made, tremendous value can be created or destroyed quickly.  Think about organizations that announce hundreds or thousands of job cuts and those that create opportunities.  It is easier to destroy than create value.

Noel Tichy and Warren Bennis defined judgment as an informed decision making process that encompasses three domains – judgments about people, about strategy and in time of crisis.

Every key business decision, strategic choice or judgment made by a leader can hugely impact the future of an organization and the lives of many people and their families.  Decisions should be followed by effective execution and both need equal attention.

Leaders have to be focused on building sustainable businesses and organizations.  This may sometimes result in difficult choices in the short run but if they miss to balance financials with employees or other key stakeholders aspects, morale drops quickly and trust gets impacted.

A recent Fast Company article noted that leadership in the future depends less on knowing things others don’t know, and more on seeing new relationships among facts available to all of us – pattern recognition.  The time honored relationship – correlation of knowledge with greater influence in business – is now dissolving, as technology dissolves knowledge monopolies.  It is not uncommon even nowadays, to see many individuals holding on to knowledge without sharing, to feel important and secure.

2. By building highly engaging organizational environments and capabilities.
Ensuring the first element alone will not work.  Leaders can influence sustainable success for the long run by engaging, empowering, motivating individuals and teams to deliver successful outcomes; creating an environment of openness, inclusion, trust, with high performance practices and systems.

For most employees, the “company” means “leaders”.  It’s not uncommon to hear employees across the world say, “The company did something.”  It is worthwhile to think, “Who or what is this company?”.

Leaders also influence heavily how employees feel about themselves and their relationship to the organization.  Studies in one of the best books on leadership (The Leadership Challenge) note that leaders understand that mutual respect is what sustains extraordinary efforts; they strive to create an atmosphere of trust and human dignity. They strengthen others, making each person feel capable and powerful.

At the heart of it, leaders create the feeling of “We” and “Us” in organizations with shared responsibility, not “You” and “Me”.

Boards, executives, shareholders and organizations at any level or sector who understand these fundamental elements and expectations from leaders will be able to build and enable sustainable and impactful organizations.

(Posted on LinkedIn)

References
1. Judgment, How Winning Leaders Make Great Calls by Noel M. Tichy and Warren G. Bennis, Summary;  http://sitemaker.umich.edu/umhs-talentmanagement/files/judgement.pdf
2. How Expertise is changing the way we work and lead; http://www.fastcompany.com/3047911/lessons-learned/how-expertise-is-changing-the-way-we-work-and-lead
3. The Five Practices of Exemplary Leadership Model http://www.leadershipchallenge.com/about-section-our-approach.aspx
4. Image Credit – https://stocksnap.io; Tomasz Bazylinski

Make Yourself Irrelevant For Higher Growth & Impact

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We tend to believe that if we stay important, at least in perception and hold on to the things we do that normally make us feel important, we become invaluable to our business and organization.  This leads to many interesting and unhealthy behaviors – including holding on to information without sharing openly, reluctance to collaborate, unwillingness to share resources, making others feel insecure, and controlling or micromanaging.  We continue to move on superficially without self reflection, personal growth and reach a stage where our egos and fears prevent us from stepping out of our comfort zones – until a major change inevitably hits us and forces us to rethink.

It may be surprising to hear and sometimes hard to accept but making yourself irrelevant will make you more valuable to the business and yourself as a leader and human being.

What does ‘making yourself irrelevant’ mean?
This means empowering and enabling team members to take up some of your important responsibilities and more.  This does not mean stepping away from your leadership responsibilities or not managing.  This also does not mean dropping your troubles and issues on others.  Rather, this is about transitioning your role to leading, developing, transitioning from being a possessive individual contributor to focusing on high impact areas for organizational success today and in the future.

Why is this important?
You create more opportunities for team members to continuously stretch, learn and grow.  You create more space for yourself and the organization for reflection, insight and action.

How can you as a leader start in this journey?
Let go of few elements that you’re currently doing for your team members.  Take a step back, let them own those elements and drive them.  Coach, support them and provide constant feedback and recognition.  Be patient through the process and reflect on the learning together.  Encourage your members to take on more challenges afterward.  Constantly build confidence.  Invite members to join key conversations and discussions.  Let them feel included.  In most cases, your team members  will step up, be happy and grateful for the opportunities to do more impactful work.

As a result, you’ll create more space for yourself as a leader to reflect, do more impactful work, innovate and explore untapped areas in personal and organizational effectiveness.  You’ll create opportunities for others to grow and do more meaningful work.  The extra space created will help stretch your thinking.  During the initial phase, it is normal to feel uncomfortable and insecure as you let go of perceived important elements or activities.  Self-compassion is important.  You’ll become more agile and adaptable to change from both the individual and organizational perspectives.  The business and organization will gain tremendously.  You will be respected as someone who can build more leaders and leadership in your organization.

Doing this successfully and developing this capability as a manager or leader will bring you more (many times bigger) opportunities within your organization. More talented individuals will want to join your team.  If not, there will be other great opportunities waiting outside.

Paradoxes At Work For Leaders

Paradox photo - Please Do Not Touch

paradox is a statement that apparently contradicts itself and yet might be true (or wrong at the same time).

Figuring out and thinking through a paradox is an important and valuable exercise in any organizational environment, for individuals and teams.  This also becomes valuable for leadership decision making and judgment calls.

Thinking through paradoxes is also extremely useful to stretch, question and develop our own thinking ability and approach.  From personal experiences, the lack of clarity and absence of active dialogues on such topics can lead to confusion, frustration and stress within organizations.  Getting caught in ‘no man’s land’ on decisions happens more frequently than we imagine.

Leaders encounter many of the following paradoxes frequently (all but one are from the book, “HR From The Outside In”).

  • Business & People
    How do you balance the tradeoff between people and business?
  • Organization & Individual
    How do you manage the tensions between individual talent and teamwork, individual ability and organizational capability? How do you balance differentiating top performers and rest of employees?
  • Outside & Inside
    How do you simultaneously understand the dynamics and operate in the external and internal environments?
  • Strategic & Administrative
    How do you balance flawless execution of administrative and operational actions with strategic adaptation to future business scenarios?
  • Short Term & Long Term
    How do you choose between short term and long term benefits, especially in decision making?

There may also be relationships to be considered among these paradoxes.  e.g., balancing the tradeoffs between business and people may need to take into consideration the balance between the future and past.

We can build clarity through a continuing, active dialogue with ourselves, our stakeholders, teams regarding our thinking, core principles and approach.  This becomes fundamental for success and increased effectiveness in a constantly changing world.

It is great to see that the 2016 RBL Group/University of Michigan HR Competency model includes ‘Paradox Navigator’ and brings out many tensions commonly faced – tensions between global and local business demands, between the need for change and stability, between the internal focus on employees and external focus on customers and investors, and between high level strategic issues and operational details.

How do you think about and manage these paradoxes?

What other paradoxes do you encounter?

(Previously posted on Linkedin)

Suggested reading:

  • Paradox – Wikipedia – https://en.wikipedia.org/wiki/Paradox
  • Book – “HR From The Outside In – Six Competencies for the Future of Human Resources”; Dave Ulrich, Jon Younger, Wayne Brockbank, Mike Ulrich; McGraw Hill.
  • Paradoxes for HR – http://www.tojoeapen.com/blog/paradoxes-for-hr/
  • 2016 HR Competency Model – The RBL Group, University of Michigan
  • Image Credit – Zach Stern, The Observer’s Paradox, http://foter.com,https://www.flickr.com/photos/zachstern/7532320120/

Leadership Trust At Any Level – 6 “Be”s

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(Posted on LinkedIn on October 21, 2014.  Modified version of a previous post on www.tojoeapen.com/blog.)

One of the most common leadership questions and challenges we come across in organizations is “How do I/we build trust?”.

This is a topic that will be constantly revisited by many, in personal and professional lives. Trust can be built more consciously through repeated, consistent actions. Every action and behavior can contribute to building or breaking trust. When a healthy mass of leaders practice trust building behaviors in an organization, it starts to shift and impact the culture positively. You can also build some of these aspects into organizational practices and systems.

1. Be visible.
Don’t get too busy with meetings and spend most time within closed doors. All stakeholders, especially your team members have a high need to see their leaders, even more when uncertainty is high. As human beings, visibility is reassuring and, builds certainty and confidence.

2. Be respectful. 
Being respectful in your direct and virtual interactions, irrespective of organizational levels are major acknowledgments and motivators for individuals. The deeper you go in an organization, the more charged up and motivated individuals feel when leaders find time for them. Respecting personal space and feelings, especially during difficult phases go a long way to building commitment and trust.

3. Be aware (of self and impact of your behaviors and actions on others).
Take time to understand yourself, what drives you, your values, principles, strengths and development areas. Self awareness is the starting point of any personal development. Next stage is to understand others around you and the impact of your behaviors on them. Trust is a two way street and someone needs to extend a hand forward first to get the process of interactions into motion. It becomes even more powerful when you extend your hand first.

4. Be authentic (consistent in behaviors and actions). 
Be yourself. Don’t try to be someone else. Most people are smart enough to see through ‘fake’ and artificial personalities. This does not indicate the license to do whatever to be yourself, rather this is about being aligned to your values and principles. Practice what you preach. Admit mistakes with accountability when they happen and share recognition when success is achieved. Explain your thinking approach because people may think differently about a certain topic and struggle to see the rationale in another person’s point of view.

5. Be open (to discussions, while being conscious of biases).
Having the openness to discuss aspects that you may not agree with and have a strong view about, may help you see different possibilities and ideas. Sometimes, it helps to be open about the fact that you have a strong view for a certain reason. It also encourages others to share ideas and thoughts without fear. Presence of fear and defensiveness are among the biggest barriers to trust. It becomes more difficult to share mistakes that may come to haunt you later, or to speak up when the perceived power distance or threat of repercussion seems high. Being vulnerable, even to some extent is a big factor for others to see your humanness and increases accessibility.

6. Be fair (in your approach and communicate clearly, especially tough choices).
People can live with tough choices if they feel it was based on a fair process and they’re not being misled into believing so. Many times, lack of visibility on the process or the way it was communicated or an absence of it, results in difficult scenarios and contradictions for everyone involved.

To easily remember, we can also use the acronym ‘FAAVOR‘ (Fair, Aware, Authentic, Visible, Open, Respectful).

It is valuable to reflect constantly. Taking out some thinking time with yourself, your close connections, coaches or mentors can help you in finding more clarity. We all have different scenarios to think about and there are no perfect solutions. Observing, reflecting and adjusting our approaches accordingly would help to figure out an appropriate approach for our environment.

Over time and with practice, building trust becomes achievable and impactful through a concrete set of actions.

 

3 Omnipresent Leadership Coaching Scenarios

Posted on LinkedIn on September 16, 2014

We see these scenarios play out in organizations every day but leaders seldom seem to act with urgency or seriousness to support development for themselves or their teams through impactful coaching. Effective leadership impacts multiple lives, not just of employees but also their families and beyond. As we experience ourselves, emotions can be contagious and many times, our good and bad emotions stay with us beyond work.

The three most common leadership coaching scenarios I’ve observed in organizations, irrespective of locations around the world:

1. Strong Individual Contributor but Weak Leadership

2. Strong Technical/Analytic Skills but Weak Emotional Intelligence, Social, Communication Skills

3. Strong Execution but Weak Strategic and Long-term Thinking Skills

Would you agree?

Ignoring these weaknesses could lead to major derailers for leaders and organizations.

I have little doubt that disengagement in organizations stems from poor leadership and HR practices. Gallup’s 2013 State of the Global Workplace report found that only 30% of American employees, 15% of German employees, 9% of French employees, 6% of Chinese employees, 11% of Korean employees, and 9% of India’s employees were engaged at work actively sharing their best ideas and giving their all for high performance.

For leaders, it is important to recognize that building self-awareness requires a lot of work. The issue becomes compounded when leaders don’t seek feedback in the right manner and are surrounded by ‘yes’ people. In addition, they don’t receive adequate support or the ‘safe zone’ to reflect and modify their approaches. This leaves many teams and organizations with unresolved toxic emotions and issues.

If you are a leader or HR professional, please consider placing leadership coaching support and related skills high on your agenda – for yourself and others.

Have you encountered other common coaching scenarios?

Reference:
From Blue Ocean Strategy to Blue Ocean Leadership
http://knowledge.insead.edu/leadership-management/from-blue-ocean-strategy-to-blue-ocean-leadership-3577

India & Global Competitiveness – Miles To Go

The World Economic Forum’s Global Competitiveness Index and report for 2014-2015 was released last week.

I am highlighting key notes on India from the report, as the topic of global competitiveness in today’s world is critical and impacts all our lives, directly or indirectly.  These notes indicate the amount of work and important contributions needed especially from our leaders, elected representatives, administrators and all key stakeholders in the public and private sectors.

The World Economic Forum defines competitiveness as the set of institutions, policies, and factors that determine the level of productivity of a country.  The Global Competitiveness Index (GCI) includes a weighted average of many components, each measuring a different aspect of competitiveness.  The components are grouped into 12 pillars: Institutions, Infrastructure, Macroeconomic environment, Health and primary education, Higher Education and training, Goods market efficiency, Labor market efficiency, Financial market development, Technological readiness, Market size, Business sophistication and Innovation.

These are the key notes on India:

  • Dropping for the sixth consecutive edition, India ranks 71st (down 11 from previous year) out of 144 economies in the Global Competitiveness Index (GCI) 2014-2015.  It is the lowest ranked among the BRICS economies.  China ranks 28th and continues to lead the BRICS economies by a wide margin-well ahead of Russia (53rd), South Africa (56th), Brazil (57th), and India (71st).
  • The rank differential with China (28th) has grown from 14 places in 2007 to 43 today; while India’s GDP per capita was higher than China’s in 1991, today China is four times richer.
  • Despite its immense potential and promise, by many accounts India continues to suffer from poverty.  A third of the population still lives in extreme poverty.
  • Overall, India does best in the more complex areas of the GCI: innovation (49th) and business sophistication (57th).
  • In contrast, it obtains low marks in the more basic and more fundamental drivers of competitiveness.  India ranks 98th on the health and primary education pillar.  The health situation is alarming: infant mortality and malnutrition incidence are among the highest in the world; only 36 percent of the population have access to improved sanitation; and life expectancy is Asia’s second shortest, after Myanmar.  On a more positive note, India is on track to achieve universal primary education, although the quality of primary education remains poor (88th) and it ranks allow 93rd in the higher education and training pillar of the GCI.
  • Transport and electricity infrastructure are in need of upgrading (87th).  Addressing the infrastructure gap will require very strong participation on the part of private and foreign investors through public-private partnerships.  For these types of investments to materialize, the institutional framework needs to improve.
  • There are encouraging signs.  India has achieved spectacular progress in various measures of corruption and now ranks 65th.  Red tape seems to be less of an issue than it had been, and government efficiency is equally improving.  However, the overall business environment and market efficiency (95th, down 10 places) are undermined by protectionism, monopolies, and various distortionary measures, including subsidies and administrative barriers to entry and operation.
  • The World Bank estimated that it takes 12 procedures (130th) and almost a month to register a business (106th).  In addition, it calculated that taxes for a typical registered firm amount, on average, to 63 percent of its profits (130th).  The labor market is inefficient and rigid (112th).  These factors contribute to the high cost of integrating more businesses into the formal economy.  Some estimates find that the informal sector accounts for half of India’s economic output and 90 percent of its employment.  It is therefore urgent that the government create the right incentives for businesses to register and contribute their fair share to the provision of public services.
  • India achieves its lowest rank among the 12 pillars in technological readiness (121st).  Despite mobile telephony being almost ubiquitous, India is one of the world’s least digitally connected countries.  Only 15 percent of Indians access the Internet on a regular basis. Broadband Internet, if available at all, remains the privilege of a very few.  India’s knack for frugal innovation should contribute to providing cheap solutions for bridging this digital divide.
  • India’s fiscal situation remains a concern, as evidenced by the country’s 101st rank in the macroeconomic environment pillar of the GCI.
  • Because of the high degree of informality, the tax base is relatively narrow, representing less than 10 percent of GDP.  In addition, over the past several years India has experienced persistently high, in some years near double-digit, inflation.
  • Despite the abundance of low-cost labor, India has a very narrow manufacturing base.  Manufacturing accounts for less than 15 percent of India’s GDP.  Agriculture represents 18 percent of output and employs 47 percent of the workforce.  Low productivity in the sector means very low wages.  The services sector accounts for just 28 percent of employment but for 56 percent of the economy.  White collar jobs remain rare.  The business-process outsourcing sector employs 3.1 million workers, or 0.6 percent of India’s 482 million strong labor force (but accounts for 6 percent of GDP).  India needs to create jobs in the “missing middle” for the 610 million youths under 25—half of India’s population— who have recently entered or will soon enter the workforce.
  • India’s competitiveness is also reduced when sustainability is taken into account.  Social sustainability is hindered mainly by the population’s very uneven access to sanitation (only 36 percent of Indians have access to these basic services) and high rates of vulnerable employment.  India’s environmental performance is also below par because the country’s natural assets are depleting.  Air quality has slightly improved, but concentrations of particulate matter and carbon intensity are still very high.  In addition, the limited treatment of wastewater is increasing pressure on India’s water tables, and limited protected areas are wearing down the assessment of the quality of the natural environment.  Although on some issues the authorities are working to improve the situation, little action has been taken on specific but significant areas of environmental management.

Improving competitiveness will yield India huge benefits.  It will help rebalance the economy and move the country up the value chain so as to ensure more solid and stable growth; which in turn could result in more employment opportunities for the country’s rapidly growing population.

There is a tremendous amount of work to be done with strong leadership focus at all levels of governance and partnerships.  It is encouraging to see India’s new prime minister and team actively putting many of these core elements among top priorities for the nation.  Hopefully, we can all contribute in our own ways to at least one of the pillars to ensure effective progress.  There is a long way to go and lots of committed work to reach our aspirations as a nation.  Like it or not, our competitiveness as a country impacts all our lives.

Best wishes…

Note: Special thank you to my Rutgers professor, Dr. Randall Schuler for actively influencing and instilling the habit of following and thinking about global reports, trends and indicators.

Reference:
World Economic Forum’s Global Competitiveness report 2014-2015

Fundamental Thinking For Healthcare Providers

How many of us have been to a hospital during the past year, for ourselves or others? Healthcare providers play a vital role in our lives.  The frequency of our visits go up over time and very few of us go to a hospital with total peace of mind.  It is important for healthcare providers to recognize this, as they play a huge role in the patient’s and family’s wellbeing.  There is more to patient care.

In India, it seems that the healthcare infrastructure has developed admirably in many places with the latest equipments, medicines and many technical services (and fees) but the quality of interactions, interfaces and emotional intelligence skills leave a lot to be desired.  On the other side, customer/patient experience and satisfaction haven’t kept up.  People are constantly on the lookout for the next best service provider and willing to pay more for better services.  We seem to have many skilled experts who have low emotional intelligence/social skills and caring approach with their patients.  Medical schools, hospitals and clinics can progress a long way by developing these skills consciously from the early school training phase and revising every ‘touch-point’ with their customers/patients across their systems.  These aspects have to be revisited constantly but first there needs to be a clear intent to change.

Emotional Intelligence (EI) can be defined as a set of abilities (verbal and non-verbal) that enable a person to generate, recognize, express, understand and evaluate their own and others’ emotions in order to guide thinking and action.  It includes two key perspectives – interpersonal (insight into others) and intrapersonal (self awareness).

So, what could we learn from related studies and research around the world?

Patients who feel that their physicians treat them with respect and fairness, communicate well and engage with them outside of the office setting are more active in their own health care.  The researchers looked at four factors: the quality of the patient-physician relationship, including how well patients felt their doctors communicated with them; how much respect and fairness patients felt they received; the involvement of the patient in setting treatment goals; and the frequency of any patient-physician communications outside of the office setting, such as email or phone calls. Each of these factors was associated with greater patient engagement, with the exception of involvement in the setting of treatment goals.  Getting patients to be more active in their own care is important and this can be decreased by a power differential in the relationship between physician and patient.

Physicians often underestimate patients’ desire for information. In one study – in 65% of the encounters doctors underestimated patients’ desire for information, in 6% they overestimated, and in 29% they estimated correctly.  Doctors’ information-giving, was significantly related to patient satisfaction.  Affective behavior (especially non-verbal behavior: eye contact, shown interest) appeared to be very important in determining patients’ satisfaction.

Low physician emotional intelligence is associated with greater illness and health care utilization.  Empathy may be the most important component of emotional intelligence in the healthcare setting.  Given the importance, even centrality, of empathy to the doctor–patient relationship, testing for empathy in medical student applications or development deserves more attention. Issues within the system, e.g.. among doctors, nurses and other staff members also affect patients.  

The results of the 2009 Doctor-Nurse Behavior Survey (American College of Physician Executives) indicated that nearly 98 percent of the survey respondents reported witnessing behavior problems between doctors and nurses in the past year.  While disruptive behavior is terrible, no matter whom the target, the problem becomes especially worrisome when it affects innocent third parties – patients and their families. It is also important to acknowledge that healthcare providers themselves need support, while having to work with very difficult environments and emotions.

A recent study in Kerala indicated that patience, care and concern of doctors and nurses, doctors’ interest in patients and the comfort provided by them were vital factors impacting patients’ satisfaction.  This seems to be aligned with the above studies.

A pivotal study shows that when the brain fires up the network of neurons that allows us to empathize, it suppresses the network used for analysis.  It is important to be aware that when the analytic network is engaged, our ability to appreciate the human cost of our action is repressed.  In short, we have a built-in neural constraint on our ability to be both empathetic and analytical at the same time.

If you work in healthcare, it would be very worthwhile to review your own self awareness, emotional intelligence and conscious development, at an individual and systemic level.  Deep expertise in medical science might lead to a heavy reliance on the analytic brain network – we need both analytical and social.

I leave you with one important question for reflection:

How would it feel if you and your family were on the receiving side of your own service?

“As healthcare professionals, sometimes we fail to see the whole picture.  We don’t see the patient, the person, the human being, the mother who had brought up a family who were desperately worried about her condition.” – Dr. Penny Sartori


References/Resources:

Emotional intelligence and patient-centred care, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1939962/

Doctor-Patient Relationship Influences Patient Engagement, November 29, 2011, Valerie DeBenedette, http://www.cfah.org/hbns/2011/doctor-patient-relationship-influences-patient-engagement

Doctor-patient interaction, patients’ health behavior and effects of treatment, http://www.ncbi.nlm.nih.gov/pubmed/6474225

Emotional intelligence and empathy: its relevance in the clinical encounter, Paul Burcher , Dove Press Journal, May 2011

Bad Blood: Doctor-Nurse Behavior Problems Impact Patient Care, Carrie Johnson, https://www.ache.org/policy/doctornursebehavior.pdf

DOCTOR-PATIENT COMMUNICATION: A REVIEW OF THE LITERATURE, L.M.L.ONG, J.C.J.M.DEHAES, A.M.Hoos, and F.B.LAMMES, http://tusk.tufts.edu/auth/pdf/529179.pdf

Role of Empathy In Ensuring Patient Satisfaction At Government Hospitals In Kerala: An Investigation, Rehin.K.R, Dr. Raveendran. P.T.

Empathy represses analytic thought, and vice versa, http://blog.case.edu/think/2012/10/30/empathy_represses_analytic_thought_and_vice_versa

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