Friday, August 19, 2016

RWL #6

this week's RWL newsletter reproduced here:

Happy Friday! Here are this weeks recommendations for your reading, watching, and listening pleasure!


What: in the HBR, To Get More Out of Social Media, Think Like an Anthropologist by Susan Fournier, John Quelch, and Bob Rietveld

Why: I've been thinking a lot about listening. It comes up frequently when I talk to executives about leadership. In this article, listening is applied at the macro/market level. According to the authors, "Social listening promises the Holy Grail in business: superior understanding of customers." What is "social listening"? The essence is customers/consumers/patients are online talking about your firm and your firm's products - whatever those might be. In a sense, your users are giving you unfiltered access to their feelings about your product. So you should listen (or read) what they are saying. But... you should listen like an anthropologist: "Anthropologists and the culturally sensitive analysts who think like them specialize in meaning management. Their function is to take complex bits of data and develop a higher-order sense of them." It is a qualitative approach to research that I am fond of - the authors' point is this approach keeps the data grounded in its context, and does not purify it in a way that quantitative approaches often do.​

(you should be able to get 4 free articles each month from the HBR even if you are not a subscriber)


What: MakerBot and Robohand | 3D Printing Mechanical Hands

Why: This is a short, inspiring video about a South African carpenter who, after losing his fingers in a work-related accident, set out to make his own artificial hand. In collaboration with an American puppet maker, they together developed a low-cost, 3-D printable prosthesis that is changing people's lives. It's really an amazing story of technology and innovation.​


What: The latest Health Leader Forge interview was with John Fernandez, the President and CEO of the Massachusetts Eye and Ear Infirmary.

Why: Mass Eye and Ear is a world famous specialty hospital focused on ophthalmology and otolaryngology. During the interview, John surprised me by recommending the One Minute Manager. He recommends the book because it has some basic advice - give people feedback and follow up (here's that listening theme again). According to John, this is a fundamental management task, and it's one that even senior executives don't always remember. Along with planning, feedback and follow up were central themes we came back to repeatedly throughout the interview.

OK – those are my suggestions for this week. If you find these links interesting, won’t you tell a friend? They can subscribe here:

Tuesday, August 16, 2016

notes on recruiting from "Winning the War for Talent"

I just finished reading Mandy Johnson's Winning the War for Talent. I wish I had read this when I was a hiring manager. Even though I worked in the federal government and had very little control over most of the variables she talks about, her tips on screening for attitude are insightful.

She talks about evaluating an applicant's past history on three factors: attitude, skills and qualifications, and practical fit (p. 80).

I've spoken with a lot of executives for my podcast, and one of the things I try to ask about is how they go about selecting leaders. I've heard a mix of answers about how they select, but when I ask them what their hardest lesson learned was, it was almost always hiring the wrong person and/or waiting too long to get rid of a poor performer, often the person they shouldn't have hired.

Skills and qualifications refers to formal qualifications like licenses (if required). It also refers to things like the quality of school the person got their degree from (or if they have a degree). So pretty straight forward and relatively objective.

Practical fit sounds a bit squishier, and has to do with whether the person is a good fit for the organization. I just released an interview with John Fernandez, the President and CEO of Massachusetts Eye and Ear Infirmary, one of the world's leading specialty hospitals, and he talks about having a good fit for leaders in his C-suite. His comment is that at that level, it isn't about skills and qualifications (which are necessary, but to get to that level, everyone is skilled and well qualified). His focus was on a good fit for the team. Most of us are never going to work in the C-suite, so Johnson's focus is more about being a good fit for the organization's mission and culture. If you don't like to travel, you're probably not a good fit for a sales job with a big territory. If you don't like sitting behind a desk, you probably don't want to be an accountant.

These latter two are pretty simple. It's attitude that is much harder to judge and Johnson spends a lot more time talking about how to try to evaluate it objectively. All of the executives I have interviewed have talked about attitude in some way, shape, or form. Johnson talks about how most of us think we can articulate what attitude is, but often we don't really have objective criteria. I agree - operationalizing attitude is challenging, especially if you are trying to do it from a resume or CV.

She offers the following five measures of attitude:

measure                            operationalization
positive work ethic          job stability
                                         early workforce participation

perseverance                    job stability
                                         completion history (broadly measured - e.g., completed levels of schooling,                                           programs)

achievement                    pattern of demonstrated achievement

works well with              job stability
people                             community involvement

commitment                    job stability
                                        targeted cover letter
                                        speed of application
                                        targeted CV

Do you think she values job stability? One of her big themes is good recruitment doesn't just mean filling the job, but filling it with someone who will stay. So job stability is a good indicator of that. But it also is a good indicator for a host of other problems. Not particularly interesting in itself, but interesting to see how important it is. Some other items interested me. I once hired a woman based on her volunteer work. She was a Navy spouse so I knew she didn't necessarily always have the opportunity for meaningful work. But she took on the family support group leadership for an air craft carrier - a ship with 5,000 crew members. Her job was to help coordinate the families and help them work through problems when their husbands and wives were off on the ship somewhere and couldn't help. And she did that as a volunteer. She was a great employee when she was being paid. Early workforce participation is another interesting point. Learning the value of work early is probably a good trait, though I have to say I never thought to ask about that. Targeted CV and cover letter are obvious to me, but I guess not to everyone.

How would you operationalize attitude? I think it's an interesting exercise.

Saturday, August 6, 2016

RWL #4

reposting here my weekly newsletter:

This week’s focus is on death and dying. I know, just in time for the weekend. But you can’t work in healthcare and not think about that topic. There is a grace in it, and part of our job as health leaders is to ensure that the people entrusted to our care are treated with dignity. This week's suggestions look at how we can help people at the end.


What: From the WP, “Dying is hard. Death doulas want to help make it easier.”

Why: My father volunteered as the medical director for Home Healthcare Hospice and Community Services for many years as part of his mission as a Catholic physician. I used to see him head off into the woods of rural New Hampshire with his black bag to check on patients on the weekends like a character out of some 19th century novel, except he was driving a pick-up rather than a buggy. As a former hospital administrator, I have seen my fair share of patients who passed while I was on duty over night, escorting their bodies to the morgue, but I’ve never sat with someone who was actively dying. As an economist, I read this article and thought about specialization, but also how utility maximization does not always mean more money. As the great economist Adam Smith said, “Man naturally desires, not only to be loved, but to be lovely; or to be that thing which is the natural and proper object of love.”


What: Dr. BJ Miller “What Really Matters at the End of Life”

Why: Really, most TED Talks are self-recommending. But Miller's personal journey is fascinating. He runs an organization called The Zen Hospice Project, which he talks about in the video. You can read about him here.


What: Health Leader Forge interview with the Rev. Frank Macht, Director of Chaplaincy, Dartmouth-Hitchcock Medical Center

Why: On the theme of death and dying, Frank and I had a great conversation about what it is like to be a hospital chaplain at one of the country’s top teaching hospitals. Frank’s story is really interesting as he traveled from Germany to San Francisco and all over the United States learning his trade, which is to journey with people who are in crisis. One of my favorite interviews.

OK – those are my suggestions for this week. If you find these links interesting, won’t you tell a friend? They can subscribe here:

I' d love to hear what you think of these suggestions, and I'd love to get suggestions from you. Feel free to drop me a line by e-mail, or you can tweet to me at @bonicatalent .

Monday, July 11, 2016

Book: "How Google Works" by Schmidt and Rosenberg

How Google Works is a quick and easy read (I am a slow reader and I plowed through this book over the weekend), but packed with some interesting perspective and specific tips.

The book highlights the fact that Google operates in the manner that Google manages human capital for talent. It is almost straight out of the pages of The War for Talent published back in 2001. Hire the best talent, take your time to get the best talent, help the best talent develop, manage under-performers out.

The book emphasizes the importance of culture, and the importance of preserving that culture by bringing in the best.

What can we learn as talent managers in healthcare from How Google Works? I've had a number of conversations with executives on the Health Leader Forge, and many of them, really a majority of them, say that the leadership lesson that they had to learn the hard way was around hiring and managing under-performers. So even though the dynamics of healthcare delivery are quite different than the frothy, ping-pong table, nap-nook filled world of internet start ups, the problem of talent management and finding the right people is still the main problem leaders face.

Schmidt and Rosenberg have some interesting recommendations - like creating a hiring committee where the hiring manager has a veto, but not the final decision to hire - makes a lot of sense. There needs to be a focus on slowing down the process to ensure organizational fit and appropriateness. Hiring by committee makes sense because as the authors point out "Hiring decisions are too important to be left in the hands of a manager who may or may not have a stake in the employee's success a year later" due to corporate movement of either the manager or the new hire (p. 121).

That's an interesting prescription and it ties back to The War for Talent, which argues that the single most important thing an executive can do is build their team.

Saturday, July 9, 2016

career mapping and transparency

Nice article on employer transparency about career development:
When career maps are paired with effective advising, employees are empowered with tools and support to own their careers and actualize their future with the company making it a win-win for both employee and company. The result is employees who are in charge of, and enthusiastic about, their careers.
When a company is committed to transparency, it forms a partnership between the employer and the employee. As the company shares its vision for the future with employees, workers will understand what the company values, and they can invest their time and energy in improving the skills they know they need to successfully advance within the organization.
rest here:

This was a thing I think the Army did and does do particularly well. Most young officers are encouraged to develop a career map early on, and most senior officers are willing to talk about their careers and to discuss junior officers' maps.

In my own research on early careerists, career mapping is something I am hearing a lot about. When an organization engages early careerists in career mapping, they seem to develop a much stronger bond with the company than when they do not. 

Tuesday, July 5, 2016

the progress of capital and talent management in healthcare

There was an entertaining article in the Popular Mechanics over the weekend about a "Jetsons-Style" burger restaurant where the burgers are prepared entirely by robotic technology:
"This location will feature the world-premiere of our proprietary and remarkable new advances in technology that enable the automatic creation of impossibly delicious burgers at prices everyone can afford"
There is still work for humans in this restaurant - someone has to take care of the machines, after all.

This is the reality of the future, and it shouldn't come as a surprise because it is also a reality of our present. Two hundred years ago, 95% of the population lived on farms and the small remaining fraction worked trades or manufacturing. We were all much poorer then. Today capital, in the form of heavy machinery, has replaced most human and animal labor on farms. Only about 3% of the population in the US works on farms now, operating and maintaining the machinery that brings us ever more food at ever cheaper prices. To be a farmer today takes a great deal of skill and knowledge about machinery and technology. It's a highly technical field. Apparently the quintessential first job for teenagers, burger flipping, one I worked myself, is headed that way as well.

Tyler Cowen, one of my former professors at George Mason, has an excellent book, Average Is Over: Powering America Beyond the Age of the Great Stagnation, where he talks about how the economy is already starting to separate into those people who can work with technology to leverage their abilities, and those who cannot. His argument, in a nutshell, is those of us who learn the skills to work with machines to produce goods and services will thrive in the future, and those of us who do not develop the skills to work with machines will not. He argues that the inequality we are seeing in America and around the world already reflects this fact.

Looking at the burger robot, what we can predict is that the people who learn how to take care of the burger robot will likely be paid much more than I was when I flipped burgers by hand in the back of a McDonald's. This is a good thing. Burgers will be relatively cheaper, and some people will make more money making burgers. But people who don't have the skills to care for robot burger makers (or other similar processes) will have to find new jobs. If your job doesn't include somehow working with machines to be highly productive, you will likely make much less money than people who do have the skills to work with machines. Working with machines (and technology) will be define whether you are well compensated in the new economy or not.

What does this mean for health care?

Over the last 50 years, health care delivery has become more capital-intensive. Diagnostics, imaging, surgery, and even medical records all rely more on progressively more complex technology than once existed. We need very different skills in health care today than we did 50 years ago on many levels. The explosion of specialties and associated staff - not just physicians, but technicians, specialty nurses, PAs, and administrators - all reflect the ever greater reliance on capital to deliver health care.

Technology in terms of organization has also advanced. The arrangements that have brought us the 15 minute physician visit, as impersonal as that may be, allow us to focus the most expensive human capital - the physician - on her/his most high value contribution, while using lower skilled labor coupled with technology to generate greater value. Larger systems allow the organization to substitute lower cost human capital for high cost physician human capital, focusing each level of labor at its highest value.

The specialties that generate the highest incomes are heavily dependent on technology. It isn't just a political outcome that specialists are paid better than primary care physicians. Specialists interface with more technology to deliver care. Like the technician who oversees the burger robot in this new restaurant, specialists interface with technology to make diagnoses and to do procedures. Administrators make more money today than they did 50 years ago because the technology in the form of organizations has advanced and yields more value than it once did.

I think it's useful to keep this technology interface in mind as we think about the management of talent in healthcare. What are our organizations going to look like in the future? There will be more technology integrated through every aspect of our organizations. Everyone from the surgeon using a Da Vinci robot to the janitors using more sophisticated technology to sterilize rooms to prevent hospital-based infections. How do we prepare for that ongoing progress? How do we position our organizations to take advantage of that progress while still maintaining profitability in the present configuration? Those are the interesting questions.

Friday, July 1, 2016

ACHE session on military transition

I'm preparing to do a study looking at the challenges of transitioning from the military health system after retirement. The ACHE had a session on the topic this past congress - some nice material: