Service!

We had another all-day leadership seminar today, which made this week rather leadership-seminar-heavy, since we had a half-day seminar Wednesday afternoon. That was on “facilitating change.” Today’s was on “service excellence.” And I’d have to admit, grudgingly, that this week’s seminars were, um . . . useful.

Regarding service: turns out that people don’t see quality, they see service. It’s moronic but I’m told it’s true. If you take your car into the mechanic and they return it to you washed and vacuumed, you’re likely to return. (Will you return even if they trash your engine? I doubt it. But I guess the point is, you’re willing to forgive minor quality issues if the service is superior.) The speaker this morning used the metaphor of a commercial airline passenger lowering his tray table to find coffee stains. The average passenger will wonder, “If they can’t get that right, how are they going to manage engine maintenance?” Similarly, a restaurant diner who gets a dirty table, dirty silverware, etc. will wonder what the kitchen is like. Is the kitchen filthy, too?

When it comes to quality metrics, Kaiser knocks it out of the park. But at least in our county, we do no better with service metrics than our two biggest competitors. So the question is how to troubleshoot and improve service while not simultaneously trashing quality.

One of this speaker’s “gems” was that we ought to beg our members for criticism. I’m not sure how to do that as part of the typical patient encounter — what, should I wrap things up with the words, “It was great meeting you today. Oh, by the way, what could I have done better?” I wonder how many people would give an honest answer to that question. I know a few patients who might reply, but I suspect most would be too embarrassed.

In other news: the world ends tomorrow at 6 PM, PST. If you don’t see any more entries here, assume that I have been raptured.

And if I am . . . boy, will I ever be pissed.

D.

Towers

This afternoon, we had our second class in the You Too Can Be A Leader! Leadership Training Seminar. (Not the actual name, but it could be.) As best I can tell, the theme today had something to do with a triangle. How you need three things to be an effective leader. Damned if I can remember what they are, but I do remember the activity with which we ended the afternoon: in groups of five or six, we had to build a tower.

We were given a large sheet of paper, scissors, masking tape, three styrofoam cups, three styrofoam plates, a few 3×5 cards, three sticks, and a marking pen. For the first ten minutes we had to plan our approach but we could not touch the materials. Then we were given eight minutes to build the thing.

Turns out, surprise surprise, that this is a well known technique for teaching team leadership skills. Our instructor followed the description given in that link closely, down to the reshuffling of members midway through the planning process.

I should have taken charge of my group but I didn’t, mostly because I have a tendency to ham things up and I had already made a spectacle of myself this afternoon*. Instead, I volunteered the biggest guy in our group, on the basis of him being the biggest guy in our group. And he got caught up in a design concept which I thought was inferior to the one I thought of (tripod base topped by a cylindrical tower). But then, I thought, how difficult can this be? I figured his design (much narrower tripod base topped by a cylindrical tower) would do fine. And, since it conserved materials, it would be a taller tower than mine, thus garnering extra brownie points.

Well, ours toppled. Turns out paper really does have mass, who’d have thunk. The win condition was: five feet tall at a minimum and able to withstand our instructor blowing on it. Ours was six feet easy, but it crumpled with a stiff blow. By which we all learned that it never pays to be an overachiever, particularly when surrounded by blowhards.

***

The other interesting activity this afternoon went like this: the instructor flashed eight words at us for five seconds, and then we had to write down what we could remember. I got seven of the eight. The eight words were all related: something like tired, bed, dream, night, and so forth. The point of the exercise was that many people came up with the word “sleep” in their lists, even though “sleep” was not one of the original words.

I did not come up with “sleep.” In fact, when the instructor said, “Show of hands, how many remembered ‘sleep,'” I blurted out, “That WASN’T one of the original words!” And then he seemed to be saying that coming up with “sleep” was a good thing, like that meant you were some kind of big picture guy. Right. I happen to think that recalling seven of eight words when you’ve only been given five seconds to look is a pretty damn impressive bit of memory, though nothing so impressive as what contestants do in the World Memory Games.

No, I’m really not sure what that activity was all about.

Next up, no doubt: we have to fall backward and trust that the others will catch us.

D.

*I really must learn that the phrase “try not to be a total douche” is not polite in mixed company.

Bad attitude

You don’t have to tell me I have a bad attitude. I know I have a bad attitude. I’m the one at the seminar pointing out that Dr. Expert really isn’t curing that many people (that, deviously, he has defined cure so as to make it look like he’s curing lots of people). Or telling the admin-trainer that the diagram on the slide she just put up might resemble a mathematical function, but has as much in common with a function as plastic grapes do with a nice Bordeaux. Or suggesting, however unsubtly, that this same admin-trainer’s Theory of Everything makes no sense in the real world.

The blather in question: John C. Maxwell’s Five Levels of Leadership. If you follow the link, you can find out for yourself what these five levels are, but it should suffice that each level starts with the letter P. That shit doesn’t happen by accident. That happens because someone wants to write a book, teach a seminar, get quoted by other self-help gurus, who knows what else.

Our admin-trainer was trying to make the point that you can’t get from level 1 to level 3 without going through level 2. I argued that the fact that you can, in fact, get to level 3 without going through level 2 is proof positive that there are serious flaws in the construct.

For sake of furthering this discussion, level 1 — the lowest level — is where people follow you because of your title. “People follow you because they have to.” At level 2, people follow you because they want to (AKA, they follow you because they like you), and at level 3, people follow you because they respect the results you’ve achieved — you’re a proven leader.

In my residency, I had six attending physicians. I had to follow all of them because I had to, so they were all at least level 1. But one of them I truly respected — when he was running the show in the OR, I always felt safe because I knew he had my patient’s best interests at heart. My patient was number one for me, as he was for this particular doc. But I didn’t like this doc. He was too weird to like. He had an off-putting mixture of arrogance and vulnerability that made him difficult to like. But I’d have followed him anywhere.

Three of my attending physicians were likable. They had good senses of humor, they were fun to hang out with when we were outside of our usual roles. Did I want to please them because I liked them? Sure, to some degree. But I didn’t respect them. They would refuse to come in to help on difficult cases, or they’d leave me in the middle of a difficult case because they had concerns more pressing than the patient on the table (heavy sarcasm intended).

Doc #1 skipped over level 2 entirely, see? And he wasn’t the only one. I can think of other chief residents and attendings whom I respected but didn’t like. Liking someone, wanting to follow their lead, really has little to do with the process. I would argue that position, too (the lowest rung) is irrelevant — to give one example, I can think of a foreign medical graduate who, while lacking position, was clearly the most qualified surgeon in the room. Others knew it too and deferred to his knowledge.

This self-help thing is just so much religion. If you don’t believe me, go to that link and watch the adoring fanboys and fangirls fall over one another singing the praises of Maxwell.

Christy Moosa says:
October 4, 2010 at 2:22 am

You mean the best idea God has ever given you, and you are honored to be his vessel. To Him be all glory, honor and power forever, Amen!

Michael Lotfy says:
October 4, 2010 at 2:46 am

To Christy Moosa: Oh you religious people, be quite and learn. It’s John’s potential that he was born to the world with it. No doubt that God is the one who planted it to him, and he does not deny it. He does not require you to remind him of it. He always mention this all over his life. Show us Christy what are you going to do in your life. John’s life speaks for him.
John, your integrity speaks for you.
Be blessed more.

Don’t mean to digress but I’m fascinated by this construction, “Be blessed more.” Is it some variant of the Wiccan “blessed be”? Theological one-upsmanship? Or a back-handed insult (“you clearly aren’t blessed enough — be blessed more“)?

Will the rest of these leadership meetings be similarly proselytic? Will we be obliged to adopt the seven traits of effective whatevers, the twelve steps of fill-in-the-blank? Must my life be purpose-driven?

Because if they are, and if we will be, and if it must, then first I suspect I’ll have to follow the 10 Steps to a Better Attitude.

D.