Work Matters

Author: supermoxie

  • Mea Culpa: The Virtues of Apologies

    The New York Times had an interesting article this Sunday called Doctors Say ‘I’m Sorry Before See You in Court, about a movement in some hospitals toward openly admitting mistakes to patients, both as a way to diffuse the tension that often leads to litigation and as way create a more open learning environment.  The early results also suggest that it is one of those instances where the misguided paranoia of the legal profession — where lawyers have counseled doctors for years to not admit mistakes — may have done more harm than good. And lawyers are starting to change their tune on this as well.  The Times reports:

    At the University of Michigan
    Health System, one of the first to experiment with full disclosure,
    existing claims and lawsuits dropped to 83 in August 2007 from 262 in
    August 2001, said Richard C. Boothman, the medical center’s chief risk
    officer.

    “Improving patient safety and patient communication is
    more likely to cure the malpractice crisis than defensiveness and
    denial,” Mr. Boothman said.

    Mr. Boothman emphasized that he could
    not know whether the decline was due to disclosure or safer medicine,
    or both. But the hospital’s legal defense costs and the money it must
    set aside to pay claims have each been cut by two-thirds, he said. The
    time taken to dispose of cases has been halved.

    The number of
    malpractice filings against the University of Illinois has dropped by
    half since it started its program just over two years ago, said Dr.
    Timothy B. McDonald, the hospital’s chief safety and risk officer. In
    the 37 cases where the hospital acknowledged a preventable error and
    apologized, only one patient has filed suit. Only six settlements have
    exceeded the hospital’s medical and related expenses.

    The question of when admitting mistakes is a wise idea and how to do it is also an area that leadership researchers have studied in recent years.  My next post will focus on that research, but as frequent readers of this blog know, I’ve always been fascinated by these issues, and have argued that the best single diagnostic question for determining if an organization is learning and innovating as it moves forward is: What Happens When People Make a Mistake?  

    P.S. The best book I know of on medical mistakes is Charles Bosk’s Forgive and Remember.  It is fairly academic, but so well-written and compelling that it is hardly dull.

    P.P.S. I was reading through old posts on Metacool and came across one that is the same spirit as my diagnostic question (I should say "our" question, as it was developed with Jeff Pfeffer). Check out Diego’s post Where’s your place for failing?

  • Shut the Damn Thing Off Or Else! Go to shutdownandprotect.com

    The project that our students in Creating Infectious Action are currently doing focuses on ways to reduce energy consumption, and thus the carbon footprint, created by the production and use of computers. We are working with a group called Climate Savers Computing, a consortium of over 150 companies.  Pretty much every major computer hardware and software firm is involved except Apple, and we are working directly with people from Google and Microsoft — which is kind of amusing to see because, although they are competitive in many other ways, the two companies are remarkably cooperative around this issue.

    Frankly, getting people to focus on how much power an idle computer is using, or to use settings that reduce power isn’t easy. Our students are finding that even the most "green" and cost conscious folks often don’t devote attention to this source of energy use and cost.  As such, I find the indirect path taken by a team that have named themselves "The Green Blood Project" does a clever job of approaching the problem indirectly. They argue — and show evidence — that leaving your computer on all the time increases the chances of getting a virus, and along the way, they provide a link to software you can download to set the power savings settings on your PC. 

    I also like the name of their website www.shutdownandprotect.com.  They do a good job of following the advice given by Huggy Rao at our conference on creating infectious action: Identify an emotionally "hot’ problem (viruses and hacker attacks in this case) and a "cool" or rational solution (shutting down your computer and downloading the power saving software in this case). 

    Check it out and pass it along.  Also, you might contact the students directly with suggestions about ways to both craft their message and ideas about how to spread their solutions.

  • Escape from Corporate America: The Book and the Quiz

    Cover_2
    Ever since I wrote The No Asshole Rule, I get a lot of requests to write endorsements,
    or “blurbs” as they call them, for the jackets of book. This is somewhat ironic as, of the four books
    I wrote, only The No Asshole Rule has no blurbs, yet it is has outsold all my other books combined. And having gone
    through the process getting endorsements multiple times, one of the weirdest
    things that happens is that my editors and literary agents always tell me “They
    don’t matter for sales, but you have to have them anyway.” So even the people who want these things
    think they are suspect.

    Regardless of the effect on sales, I do
    enjoy being asked to write blurbs. I turn down most of the requests as I only
    endorse books that I like a lot. Of the half-dozen book or so I’ve endorsed in the past year, perhaps the best is Pamela
    Skillings’ brand new Escape
    from Corporate America.     This lovely book blends tools to help you
    decide if you ready to make your escape, great advice about to how to implement
    it, and compelling stories about people who have made the escape.  I also love the cover. 

    I think the book especially resonates with me
    because I seem to be surrounded with so many people who have made the escape.  My wife Marina did so after 25 years at her
    law firm and is wildly happy in her new job as CEO of the Northern California
    Girl Scouts.
    I also do a lot of teaching at the
    d.school with Debra
    Dunn     and Michael
    Dearing    , both of whom have made recent escapes – from HP and eBay in their
    cases. And Pam wrote this book — her
    first book – because she made her own escape and it made her curious to learn
    more. In my blurb, I said it is the best
    career book I’ve read – and that is still how I feel about it.

    Check out Pam’s blog as it is filled with information.  Also, as I learned from ARSE, everyone loves quizzes,
    so here is Pam’s quiz, which I found unusually useful

    QUIZ: ARE YOU A CORPORATE CASUALTY?

    From ESCAPE FROM CORPORATE AMERICA by
    Pamela Skillings

    Do you really need this book? Are you just
    having a bad week or are you at the end of your rope?  Take this quiz to
    find out if you need to make an escape from Corporate America.

    1. Rate your general job satisfaction:

    a. I love what I do.

    b. I have more good days than bad days.

    c. It could be worse, I suppose.

    d. I hate my job.

    2. If you won or inherited a million
    dollars tomorrow, would you continue on the same career path?

    a. Definitely.  I’d take a great
    vacation and buy a few toys, then get back to work.

    b. Probably not.  With a financial
    cushion, I would likely take the time to explore my options.

    c. Hell, no!  Are you crazy?

    3. Which statement best expresses your
    feelings toward your job?

    a. I enjoy what I do for the most part.

    b. Sometimes I fantasize about quitting to
    do something else.

    c. I am actively exploring other career
    options.

    d. I only stay in my job for the paycheck.
    If money weren’t an issue, I would leave.

    4. What are your long-term career goals?

    a. I am on a good career path, and my
    current job is a step along that path.

    b. I feel a bit stuck and unsatisfied, but
    I’m not sure what I want to do instead.

    c. The idea of staying on my current career
    path for the rest of my life gives me the cold sweats.

    5. Are you pursuing your dream career?

    a. Yes.

    b. I’m not sure.

    c. No.

    6. Do you get the Sunday-night blues?

    a. Not really.

    b. Sometimes.

    c. I get the every-night blues.

    7. How do you feel at the end of an average
    workday?

    a. Proud and happy.

    b. Tired, but satisfied.

    c. What was the point?

    d. Miserable.

    8. Where do you see yourself in five years?

    a. In a bigger job at my current company or
    at a similar firm.

    b. On a different career path within the
    corporate world.

    c. I am actively exploring other career
    options.

    d. I only stay in my job for the paycheck.
    If money weren’t an issue, I would leave.

    9. Do you feel energetic and positive at
    work?

    a. Most of the time.

    b. Occasionally, but not as much as I’d
    like.

    c. Rarely or never.

    10. Which of the following are among the
    positive aspects of your current job?  Check all that apply.

    __ Interesting work.

    __ Growth opportunities.

    __ Great boss.

    __ Pleasant co-workers.

    __ Fair pay.

    __ Good benefits.

    __ Flexibility.

    __ Fulfillment.

    __ Pride in what I do.

    __ A company that cares about me and/or
    treats me well.

    11. Which of the following are among the
    negative aspects of your job?  Check all that apply.

    __ I spend excessive amounts of time in
    meetings, documenting meetings, and scheduling follow-up meetings.

    __ I can’t remember the last time I felt
    truly excited about a work project.

    __ I put in long hours mostly because of
    other people’s ego trips.  This includes face time, cleaning up messes, or
    staying late because others screw up or delay decisions.

    __ I need at least two levels of approval
    on any decision.

    __ Knowledge and ability are less important
    than who I know and how well I can BS.

    __ I’m not quite sure what my job
    accomplishes, aside from making money for shareholders and senior management.

    __ I don’t feel passionate about anything I
    do at work.  It feels like I’m putting in time for a paycheck.

    __ I dread going to work most mornings and
    come home exhausted.

    __ I don’t see a future that I can get
    excited about.

    __ I have been a victim of or a witness to
    bullying or blatantly unfair treatment.

    Calculating Your Score:

    * For questions 1-9, give yourself 3 points
    for every A answer, 2 points for every B answer, 1 point for every C answer,
    and 0 points for every D answer.

    * For question 10, give yourself 1 point
    for every item you checked.

    * For question 11, deduct 1 point for every
    item you checked. Deduct 2 points each for checking either of the last two
    items.

    What Your Score Means:

    28-37 You are ridiculously satisfied.
    Against all odds, you love your corporate job.  You might want to
    read on for a true appreciation of just how good you’ve got it.

    17-27 You are on the fence.  Your
    corporate job is okay, but something is missing.  If your current career
    isn’t your true calling, what is? This book can help you explore your options.

    6-16  You are disgruntled.  You
    don’t like your corporate job, but you’re trying to make it work.
    Unfortunately, your feelings of frustration and rage may be starting to
    take a toll on your personal life.  Read on for some solutions.

    Less than 5  You need an intervention.
    Stat.  Your corporate job is making you miserable.  You desperately
    need to read this book and figure out your escape plan.

    I just took the quiz, and I
    scored 32. I better count my blessings.
    I complain about Stanford now and then and even tried to escape to UC
    Berkeley once. It was a most instructive failure, as I realized that the Stanford
    Engineering School was a much more flexible and open-minded place than the Haas
    Business School at Berkeley. I also learned to ignore my salary, and
    especially, to not use it as an indicator of my self-worth. I took a huge
    (about 35%) pay cut when I returned to Stanford (because business schools pay a
    lot more than engineering schools). I’ve
    always said that it was one of the best decisions I ever made and Pam’s book and quiz reinforces
    the point.  Also, in my exit interview, I told the Berkeley dean that one of the reasons that I was leaving the UC Berkeley was BECAUSE of the pay system. They had one of the most dysfunctional pay systems I have ever seen (it wasn’t her fault, that is how the entire university operated), as it seemed to mostly reward people for going out to other schools and getting large offers — which it often matched, or failing that, at least gave faculty big raises. As such, the smartest faculty, or at least those most motivated by money (or perhaps those who were massively underpaid) seemed to devote huge chunks of their time to looking for jobs in other places rather than devoting energy to helping their home institution. Stanford is sensitive to the market, but is much better about rewarding people for giving back to the institution and NOT rewarding people who are constantly trying to game the system with external offers. I think everyone — including the students –win as a result.

    Back to Pam’s book — I think it is going to a best-seller, at least it deserves to be one. I also think the timing is good as lots of people are being forced out of jobs and, even for those who aren’t, things can be lot less fun as companies push to cut costs and salaries and to squeeze ever more of every employee.

    P.S. If you buy the book and love
    it as much as I do, please write Pam a 5 star review on Amazon or Barnes &
    Noble. When a book is brand new, especially
    for a first-time author like Pam, those kinds of things really help.

  • Fold Your Arms — You Will Try Harder and Generate More Ideas

    Dale_jarett
    This study is courtesy of the BPS Research Digest blog, which as I have written here before, does a lovely job of summarizing psychological research from peer review journals.  They describe an experiment which found that, when people cross their arms, they persisted twice as long when presented with anagrams that were impossible to solve, and when presented with anagrams that had multiple solutions, subjects who crossed their arms generated more solutions than subjects who kept their arms at their sides.  The researchers speculate that this happens because "over
    many years, the act of crossing our arms comes to be implicitly
    associated with perseverance, so that adopting that position activates
    a nonconscious desire to succeed."  The researchers also caution that folding arms can be a sign of social distance (and I would add, a sign that people are uptight or trying to dominate others). 

    Next time I am in a group that is facing difficult task, I am going to suggest that we all cross our arms and see if it helps!

  • Venture Capitalist John Doerr: Another Fan of College Dropouts

    nDoerr
    I put-up a post a few months back about the long list of successful Stanford dropouts, from Tiger Woods to the founders of Yahoo! and Google.  I was reading the San Francisco Chronicle this morning, and was amused to see one of the most successful VC’s in the valley seems to actively seek dropouts, with an added twist. I quote:

    Doerr likes to invest in "white male nerds who’ve dropped out of
    Harvard or Stanford, and they have absolutely no social life." That’s
    why he backed Netscape, Amazon, Yahoo and Google.

    I do wish Doerr would have left out the "white male" part, and in fact at least one of the founders of these companies, Jerry Yang from Yahoo! is Asian; and I would add that Kleiner Perkins, Doerr’s firm, is well-ahead of other VC firms when it comes to hiring women and I understand that Doerr has been especially supportive of women in the firm with young families.

    Finally, this isn’t the first time I’ve heard a famous VC make a similar argument; I once was talking with Arthur Rock, the primary VC for both Apple and Intel, and he commented that when an entrepreneur has too nice a car or looks too perfectly groomed, he takes it as a sign that the person isn’t obsessed enough with their work!

  • New d.School Executive Program: Do You Want to Learn How to Act Like a Design Thinker?

    Tire_change_2
    The Stanford d.school and Stanford
    Business School have joined together to offer a new executive program for
    people who want to immerse themselves in the design thinking process. This
    program, called Design Thinking Boot Camp: From Insights to Innovation is
    the next logical step after the Customer-Focused Innovation class that
    Huggy Rao and I teach every November, which combines traditional lectures and
    case studies with hands-on d.school type experience – as you can see in earlier
    posts here,
    here,
    and here.
     Bootcamp
    is mostly hands-on. The pictures are from the hands-on experiences that we
    gave executives in our Customer–Focused Innovation executive program last
    November — and reflect the kinds of experiences that executives get in both
    programs (although Bootcamp emphasizes that "doing" part nearly 100%,
    and Customer-focused Innovation is roughly 50% traditional case-style
    discussion ("clean models" we call it) and 50% hands-on stuff
    ("embracing the mess of innovation" we call it).

    People_kerry_oconnor_top
    Here is the description of the new program
    from Kerry O’Connor, the d.school Fellow who is leading our executive education
    efforts (she is pictured to the left). Sounds like a lot of fun and, I can assure you, that you will learn a
    lot if you sign-up.


    Proto_preso
    Design Thinking Boot
    Camp: From Insights to Innovation     offers executives the chance to learn design
    thinking — a human-centered, prototype-driven process for innovation that can
    be applied to product, service, and business design. We believe that innovation
    is necessary in every aspect of business, and that it can be taught. We invite
    you to join us at the Hasso Plattner Institute of Design, affectionately called
    "the d.school," for an experience that will enhance your ability to
    drive innovation in your organization.  The 3-day program will take place
    July 7th through the 9th, 2008.

    The d.school design
    thinking process is user-centered and prototype-driven. As a participant in
    Design Thinking Boot Camp, you will be part of a small multidisciplinary team
    and work through a hands-on innovation challenge from start to finish. You will
    walk away from the workshop with a strong understanding of the key tenets of
    design thinking and be able to execute them at home.

    Key Takeaways and Tenets
    of Design Thinking

    • Develop Deep Consumer Insights: If you are looking for insights about
      your consumers that your competitors don’t have, our field observations and ethnographic methods will take you beyond the limitations of
           traditional market research. Our tools will help you to understand how to
           tap into what is meaningful for consumers and to uncover what they need.
    • Reduce Risk and Accelerate Learning Through Rapid Prototyping:
           If you are responsible for launching new products and services into the marketplace, design thinking can help you to greatly reduce the risk of failure and accelerate organizational learning through an iterative process of prototyping and user testing.
    • Drive Towards Innovation, Not Just Incremental Growth: Uncover and capitalize on the
           unexplored innovation spaces in your business or industry.
    • Empower Your Employees To Be Innovative: If you seek to unlock the creative potential of your organization, design thinking can help you to transform your organizational structure and internal processes so that your business shifts to a more innovative stance.

    To learn more about the
    program and how to apply, look here.
    There is room for just 35 executives in the Boot Camp, so apply early to
    enhance your chance of being admitted. 

     

  • The ARSE Test Passes 150,000 Completions

    I just got an email from Emily over at Electric Pulp indicating that the ARSE test — the Asshole Rating Self-Exam — recently surpassed over 150,000 completions (152, 234, with a mean of score of 6.4).  So the self-examination continues. A lot of people continue to take the test for themselves and others, as over 5000 people a month are still taking it.

    I also have a number of other "ARSE Tools" out there, although none are nearly as successful as the original ARSE Test.

    The next most popular is the ACHE, the Asshole Client from Hell Exam, for determining if your client is a certified asshole. This was inspired by this beleaguered fellow at a professional services firm.  We’ve had 12,180 completions, with a mean score of 14.3 (very high, this is out of 20, I guess there are lot of asshole clients out there, or at least people who have asshole clients are attracted to the ACHE.)

    The Flying ARSE hasn’t been nearly as popular, this is a self-test to determine if you are the kind of person who makes air travel miserable for everyone. A total of 7582 have completed the flying ARSE, and the mean is 3.82 out of 24, which suggests that most people see themselves as civilized passengers. But, boy, do the bad ones stand-out (I was literary knocked down by an overly aggressive passenger in Newark the other day, who decided that he had to get off the plane first the other day — and I wasn’t the only victim.)

    Finally, bringing-up the rear is ARSEmail, a kind of e-card that you can send to apologize for being an asshole to co-worker or to express sympathy to the victim of a workplace asshole. The ARSE mail has always been my favorite, but perhaps that is just a rationalization because it took longer to develop than the others. But it has not exactly caught fire, as only 703 have have been sent. By the way, when Guy Kawasaki saw the ARSEmail, he predicted that it would not be very viral because it was too complicated to complete. I guess he was right, and of course, when it comes to predicting and crafting things that people will spread on the web, Guy has a mighty good track record.

    I would be curious if people have any other ideas about why some of these ARSE tools have been so much more viral than others.  And if you have any ideas about other experiments that I might try with different web-based surveys and the like, let me know.  They aren’t that hard to do — at least all were pretty easy (thanks to the people at Electric Pulp) except perhaps for ARSEmail.

  • The Semmelweis Reflex and Why Being Right Isn’t Enough To Provoke Change

    Ronny Kohavi is the General Manager of the
    Experimentation Platform at Microsoft, his group has developed and is spreading
    the use of  tools that allow people within
    Microsoft and external developers to do controlled experiments with users,
    and that way, potentially develop better and more usable software . You can
    read about this EXP Platform here. Clearly, Ronny is someone who cares about and
    understands the power of evidence-based practices, and as such, we have been
    exchanging emails about the work that Jeff Pfeffer and I have done on
    evidence-based management in our book
    and our website. 

    Ronny is generally supportive of our approach,
    but has pushed me to emphasize that controlled experiments are the gold
    standard of science and that we should have pushed people to use them more, and
    included more examples. I partly agree
    with Ronny, as there are times when experiments aren’t used but can yield
    better practices – as we talk about in the book, Gary Loveman at Harrah’s did
    use experiments as one of the methods (along with data mining) to overturn
    deeply held assumptions in the gambling industry. But I argued that there are
    also times when an experiment wasn’t possible, for example, in the case of the
    now apparently aborted Microsoft/Yahoo! merger, the only decent evidence I know
    of that provides guidance are correlational studies, as no one has yet been allowed
    to do controlled experiments of the conditions under which mergers fail or
    succeed,

    BUT
    I do agree completely with Ronny that we need more experiments and, as the
    history of medicine shows, it is important to have the strongest possible data
    because – even when you have it – convincing people to abandon a bad practice
    can be remarkably difficult when they believe in its efficacy, are skilled at,
    and everyone around them has always done and believed in it. We wrote about
    bloodletting as an example, but Ronny wrote me about an even more interesting
    and terrifying case:

    Dear Bob,

    One of the examples was
    the bloodletting trials by Pierre Louis, but I was reminded of a better
    example: Semmelweis’s Childbed Fever. The Semmelweis Reflex is the
    dismissing or rejecting out of hand any information, automatically, without
    thought, inspection, or experiment. Anyway, here’s a summary.

    Ignaz Semmelweis’s
    Childbed Fever

    The story below is
    mostly from the book Leadership and
    Self-Deception    .  The story is corroborated by multiple sources
    including Encyclopedia
    Britannica    , Childbed Fever: A
    Scientific Biography of Ignaz Semmelweis    , and Wikipedia.

    Semmelweis was a
    European doctor, an obstetrician, in the mid 1800s.  He worked at Vienna’s
    General Hospital, an important research hospital.  The mortality rate in
    the ward where he practiced was one in 10 – one in every ten women giving birth
    there died!   The reputation of Vienna General was so bad that women
    preferred to give birth on the street and then went to the hospital.  In
    the book Childbed Fever, they estimated that 2,000 women died each year
    from childbed fever in Vienna alone.

    The collection of
    symptoms associated with these deaths was known as “childbed fever” or
    Puerperal fever.   More than half the women who contracted the
    disease died within days.  Patients begged to be moved to a second section
    of the maternity ward where the mortality rate was one in fifty – still
    horrific, but far better than one-in-ten in Semmelweis’s section.

    Semmelweis became obsessed
    with the problem.   He tried to control for all factors, including
    birthing positions, ventilation, diet, and even the way laundry was done.
    The one obvious difference between the sections was that Semmelweis’s section
    was attended by doctors, while the other section was attended by midwives.

    After a four-month leave
    to visit another hospital, he discovered that the death rate had fallen
    significantly in his section of the ward in his absence.  His inquiries
    led him to think about the possible significance of research done by him and
    the doctors on cadavers.  Yes, cadavers.  Semmelweis spent far more
    time doing research on cadavers than other doctors.

    Vienna General was a
    teaching and research hospital and many doctors split their time between
    research on cadavers and treatment of live patients.  The doctors in his
    section performed autopsies each morning on women who had died the previous
    day, but the midwives were not required or allowed to perform such
    autopsies.  They hadn’t seen any problem with that practice because there
    was as yet no understanding of germs.

    Semmelweis concluded
    that ‘particles’ from cadavers and other diseased patients were being
    transmitted to healthy patients on the hands of the physicians.  He
    experimented with various cleansing
    agents     and instituted a policy requiring physicians to wash their
    hands thoroughly in a chlorine and lime solution before examining any
    patient.  The death rate fell to one in a hundred!

    What is surprising about
    this story isn’t the discovery through attempts to control for factors, which
    led to the unthinkable conclusion (at the time) that there was something
    invisible that was transferred by the doctors.   What is really
    shocking is how long it took the community of doctors to accept the results.

    According to Encyclopedia
    Britannica    , the mortality rate in Semmelweis’s division fell from
    18.27% to 1.27% in 1848.  That was not enough to generate sufficient
    recognition and in 1849 he was dropped from his post at the clinic and turned
    down for a teaching post.  Semmelweis spent the next six years at a
    Hospital in Pest, Hungary, where he reduced mortality rate in the obstetrics
    department to 0.85% while in Prague and Vienna the rate was still about 10% to
    15%.   

    Vienna continued to
    ignore his recommendations.   In 1861, he published a book, but the
    community rejected his doctrine.  In 1865 he suffered a nervous breakdown
    and was taken to a mental hospital, where he was beaten by asylum personnel and
    died.  It took another 14 years for the discovery to be accepted, after
    Louis Pasteur, in 1879, showed the presence of Streptococcus in the blood of
    women with child fever. Semmelweis is now recognized as a pioneer of antiseptic
    policy.

    This story is instructive on many levels; the
    first thing that comes to mind is that developing the best evidence and
    practices is often even less than half the battle. Ideas that spread and stick
    need to be sold well too. That is the
    main idea behind our d.school class on Creating Infectious Action, and great
    books like Influence
    and Made
    to Stick    .

    P.S.
    Ronny, thanks for all your great ideas and for sharing this story.

  • Another Asshole Infested Hospital

    As I’ve written, I first saw how abusive hospitals could be — especially surgeons working in the operating room — when my collage Dan Denison spent a week observing a team of operating room nurses in the early 1980’s.  The worst actions we were by a surgeon we dubbed Dr.Gooser.  And I was writing The No Asshole Rule, and since I started writing this blog, I’ve encountered more and more research, and been told more and more stories, suggesting that nurses are among the consistently bullied workers, and doctors are often the culprits.

    I just got a long, sad, and quite articulate email from a scrub nurse who feels trapped in one of these asshole infested places.  I suggested that if she could possibly get out, that might be the best thing for her mental health, but it is unclear that she has this option. If not, as I’ve written in my tips for victims of assholes, this might be one of those cases were organized action could help, but she and others have tried that too. Despite my hesitation about recommending legal action, this just might be a case where that is the best option. Read it and tell me — and especially her — what you think is her best course of action.  Here is the email with only the names removed to protect innocent and the guilty — she first presents what I found to be a very thoughtful contrast between Frankl’s classic and The No Asshole Rule, and then gets on to her difficult cas:

    I read your book.  You said that we could write to
    you, so I am.  Right after reading Viktor Frankl’s book "Man’s Search
    For Meaning", I read your book.  There are a lot of similarities
    between the two books about how to get along in a bad work
    environment, even though the content is different.  Frankl survived
    four Nazi prison camps and wrote about it.  I read Frankl’s
    book and then re-read it, typing important passages into my computer since it
    was a library book.  By the end, I realized that I should have just
    bought the book.  Anyway, if you do a quick read of the first half of his
    book (before the section on Logotherapy), you will see that the similarities on
    how to deal with the SS and how to deal with today’s work bullies are
    similar. 

    I’ve read most of the how-to-deal-with-bullies-at-work books
    and I think yours is the most pragmatic.  You use multiple scientific
    articles to back up your ideas.  Furthermore, most of the other bullying
    books only deal with what to do if you’re the CEO or middle management.
    If there is a section on what to do if you’re a peon, they were obviously
    written by non-peons and their suggestions were not practical  (i.e. quit;
    go to HR and complain <HR sides with the bully>; explain yourself to the
    bully; work harder, maybe it IS you after all; support anti-bullying
    legislation).  Your book gets into the psyche of the asshole/bully and is
    more helpful to the peons with better suggestions, even though you cover
    the CEO’s, too. 

    Some of your suggestions overlapped Frankl’s solutions which
    were: know what you’re getting into before you accept "the job"; let
    fate take its course and learn to tolerate the abuse; appreciate the good
    things that happen; escape if you can; avoid the assholes in life if
    possible; keep your mouth shut and blend in; always let them see you working
    hard; fantasize about other things; become apathetic to your abuse or other
    people’s abuse; die with dignity by not succumbing to becoming an asshole
    yourself.  One thing he said that you didn’t that I thought might help in
    another publication was that the prisoner/worker should develop
    relationships with lateral next line up managers.  In his situation, they
    were called Capos–inmate prisoner first-line supervisors.  In our day, it
    would be considered shmoozing or networking with lateral managers (not
    your own) so that some day, you may get to make a lateral move out from under
    an abusive boss or maybe another lateral manager that you have befriended will
    put in a good word for you.  Frankl thought that contemplating winning the
    war was pointless.  I bet he’d think that anti-bullying legislation was a
    pie in the sky idea and didn’t help the bullying victim in the ‘here and
    now’.

    I work with cardiac surgeons.  They are all pretty much
    cut from the same cloth.  They’re all certified assholes, except for
    one and I’ve worked with many over the years.  I’ve been working with one
    really mean surgeon on a daily basis for 20 years now.  He throws things,
    calls us names, charges at us like he’s going to punch us or shove us, he
    screams incessantly, he makes jokes about whoever is or isn’t there for the
    amusement of the team.  The team has exhibited mobbing behavior and help
    to laugh at or target whoever is the target of the day, then they go pat the
    target on the back after the 8-10 hours of abuse as a parting gift for being
    the abuse receptacle for the day. 

    Several years ago, the surgeon went absolutely nuts and pushed
    a huge table full of heavy instruments.  Someone caught it before it
    slammed a nurse into the wall who had her back to the flying table.
    It could have killed her.  He physically backed up one of the scrub techs
    against the wall and shook his fists at her, his face beet red and his whole
    body shaking with anger.  This type of behavior went on for hours as the
    case dragged on.  He threw things, he screamed and called people
    names.  In his eyes, everyone was incompetent!  He was hoarse from
    all of the screaming.  The anesthesiologist (a doctor) who witnessed the
    whole thing said that the target should have called a lawyer.  Did he go
    to bat for her to administration?  No.  Did he try to stop the
    surgeon from ranting?  No.  After the ordeal, one of the other scrub
    techs wrote a synopsis of what happened and reported the doctor to Human
    Resources for what he did.  Doctors at our hospital are
    self-employed.  They are not employees of the hospital.  Furthermore,
    they bring in a lot of business.  They are in the asset column, we are in
    the debit column.  We are there to serve the physicians.  A case was
    built against the girl who filed the complaint.  They looked into her EAP
    (work sponsored counseling) files to find out if she had gone for counseling
    (against the law).  They looked into her medical claims to see if she had
    any counseling and found that she had gone to counseling (also against the
    law), and she had, for marital counseling.  They called her into the head
    physician’s office and asked her if she was making this claim against the
    physician because she was unhappy about the outcome of a surgery that the
    physician in question had performed on her nephew (how did they know that?),
    but she wasn’t unhappy with the way the surgery went on her nephew.  He wanted
    to know why she was getting counseling.  She just reported what happened,
    that’s all.

    The head of HR had a meeting with the scrub tech that the
    surgeon directed his anger at, and three other members of the team.  Other
    members of the staff who were helping out that day and not members of the
    regular cardiac team, including the anesthesiologist, were not asked to attend
    the meeting.  The scrub tech who made the claim was not asked to
    attend.  The HR Director leaned over, pointed at the intended recipient of
    the question and got in everyone’s face, and asked them one at a
    time, "A___ (the scrub tech who reported the incident) writes here
    that she thought that Dr. Y. was about to physically attack B___.  Did YOU
    think that Dr. Y. was going to physically attack B___?"
    "Yes."  "Did YOU think that Dr. Y was going to physcially
    attack B____?"  "Yes."  Did YOU think that Dr. Y. was
    going to physically attack B____?"  "Yes."  "B____,
    you did not report this incident.  Why didn’t you report this
    incident?"  B____ said, "I need this job."  She did
    not explain that she just bought a house and she found out she is pregnant and
    her husband had just been laid off from his job.  He leaned forward and
    asked B____, "B_____, did YOU believe that Dr. Y. was going to physically
    attack you?"  "Yes."  "Then why didn’t you report
    it?" he asked.  She said, "I need this job.". 
    He fell back against the back of his seat and grimaced as if to say,
    "I don’t believe it.  Who would put up with that?"  And
    then she leaned forward, and again repeated the words with conviction, "I
    NEED this job."  She got paid a little over $10/hour.  All
    this for $10/hour.  The outcome was that Dr. Y was sent to ONE anger
    management session.

    Fastforward about 7 years.  This type of thing
    continued to go on, but we learned that we were expendable so no
    one complained any more.  We learned that it didn’t help.
    Occasionally when Dr. Y misbehaved because he couldn’t get what he wanted
    because of a Department of Health policy and the nurse in the room was
    trying to uphold the state policies (the RN gets fired when the doctor breaks
    the State Health Department rules), he would call the head physician of the
    hospital who would tell the nurses that he has permission to break the rule,
    just this once, again.  One day recently, Dr. Y. went nuts on another
    unit, not in the OR.  A group of nurses wrote him up,
    again, not knowing that it doesn’t matter.  After that, he was told
    that he has to attend another (as in one) anger management class and has been
    put on probation.  Probation?  That means that we’re supposed to
    watch him for poor behavior and report it, right?  Except that they never
    told US in the OR that he’s on probation or that he was sent to anger
    management.  They are only telling nursing floors that do not interact
    with him that he is to be watched.  Therefore, those of us who COULD
    report about him were kept in the dark.  Not that it matters, of
    course.  They wouldn’t do anything about it.  That same week,
    an anesthesiologist punched a new nurse in the arm and then shoved her
    into a wall. There were four witnesses.  A non-witness was asked to
    write up the incident to report it to the head physician.  The punched
    nurse had a big bruise on her arm the next day.  The abusive  anesthesiologist was
    sent to the head physician’s office of the hospital by the acting OR nurse
    manager.  He was told by the head physician of the hospital that "he
    would be watched".   Watched for what?  And by whom?
    The partner of Dr. Y, (Dr. X)  heard about this and smiled and said aloud,
    "Oh boy!  It’s open season on nurses!"  Dr. X is currently
    being investigated by Child Protective Services for beating his own son
    repeatedly.  As for the temporary head nurse of the OR, she is replacing a
    nurse with backbone who told the doctors that their abuse couldn’t go on.
    The former head nurse of the OR had been told by senior management that senior
    management supported her efforts to curb the physician abuse
    problem.  Then they demoted her.

    The irony of all of this is that our marketing campaign for
    our hospital is "Great Place To Work, Great Place to Recieve Care and a
    Great Place to Practice Medicine".  Yeah.  There are other
    stories I could tell you, like the one about an RN with Lou Gehrig’s
    disease not moving fast enough for a surgeon so he threw three big, long,
    bloody laparscopes at her one at a time, each time hitting her.  She
    couldn’t dodge quite fast enough.  It was reported. Nothing
    came of it.  That same surgeon shoved a male scrub tech off of his stool a
    total of three times, too.  Apparently, if you can go three rounds
    with this surgeon, you’ve survived that episode. The male scrub tech
    did not report his incident with this physician because he didn’t want to
    look like a whimp.    When physician abuse events are reported,
    they are reported to the head physician of the hospital.  We think that
    the CEO has an active "kill the messenger" program so nobody gives
    him bad news, including the head physician.  I am cutting the CEO slack in
    my mind because I can’t believe that he would do absolutely nothing about
    all of this abuse if he just KNEW about it.  He must be kept in the
    dark on these issues.  I thought for sure, that after Dr. Y’s table
    throwing incident and threatening to hurt B____, that it finally would be dealt
    with.  It was just too big to ignore. But no, nothing happened,
    except for the anger management class.  Oh wait a minute.  I just
    remembered.  One of Dr. Y’s ex-partner physicians became an
    administrator.  He and another administrator presented a business
    case (financials) against Dr. Y to senior management showing how Dr. Y isn’t
    just an asshole, he’s a screw-up and his screw-ups are costing the hospital x
    number of dollars.  Yes, the CEO finally took action.  He fired the
    two administrators for plotting against Dr. Y.  You see, Dr. Y is in
    a protected class.  Dr. Y brought in a lawyer to the meeting saying he was
    being "harassed".  Case closed.

    Honestly, they tell us to "document, document,
    document" when it comes to abuse.  But when it IS documented,
    the doctor gets a slap on the wrist (anger management times two–oh yes, and he
    had to apologize this time) and there is fallout on whoever reported it.
    A manager actually told us that senior management considers the nurses dealing
    with Dr. Y as "bunch of whiners".  Without documentation,
    there’s no case.  With it, there’s retribution.  What does the CEO
    really want?

    For myself, the biggest sense of disappointment in this
    whole issue isn’t that I’m bullied by assholes.  It is the fact that the
    CEO sits on his lilly white ass and turns his back to it.  My anger
    for the bullies in my life is dwarfed by how angry I am at
    the administration and the CEO who allows it to continue, gives
    doublespeak about how it won’t be tolerated here (great place to work and all
    that bullshit)—and then tolerates it, offering any one of us up for a
    human sacrifice on a silver platter at the request of the biggest bully
    monster physicians.  That’s what makes me so fucking angry, disappointed,
    and disillusioned with the spineless, eunuch "leaders" where I
    work.  They couldn’t last one day in my job with the abuse that is hurled
    at me.  These nutjob doctors always look psychotic, like they are one
    hair’s breadth away from pounding the shit out of me or my co-workers and from
    what we have seen in the last month, it isn’t just possible or probable, it’s
    real.

     

    After the "table throwing incident"  I made
    an appointment with a psychiatrist because I was so disillusioned and depressed
    with how the administration handled that situation.  I really felt that I
    was being fed to the lions and nobody could or would help me.  I
    would go to work and just shake.  I’d be on the verge of tears all
    day.  The psychiatrist started me on anti-depressants to get through the
    day.  There aren’t enough anti-depressants in the world to fix this.
    My psychiatrist told me, "I want you to know that I’m putting the wrong
    person on anti-depressants.  You’re not the only patient I see because of
    Dr. Y."   She eventually diagnosed me with PTSD.  She said that
    she treats cops, too, who have PTSD and she said our problems are
    identical.  At least the cops are the ones who are supposed to be "in
    charge" and they can defend themselves with a gun, if necessary.  She
    said she could put me on disability for six weeks, but I refused.  How
    would that look?  Who would hire me after that?  I have begged my
    spouse to let me quit this job, but my salary pays the mortgage and as I
    said, with the type of work I do, the type of people I work
    with are the same everywhere you go. (I know because I’ve been around.)
    I went back to college part time to learn a new skill.  After
    graduating, I couldn’t get a job in that skill without moving out of the
    area and my family won’t move.  So I’m stuck.  Until I finally
    have a stroke or heart attack of my own and then I’ll be free.  What a
    price to pay.

    P.S. Dr. Gooser was also a cardiac surgeon. 

  • INC Story on Tranquilo Bay: A Tale of Tough Entrepreneurship and Resilience in Paradise

    Jim_and_jay_2
    I wrote several months back about the wonderful vacation that my family had at Tranquilo Bay, an island "ecoresort" in Panama.  The two couples who run the place (and live there with there kids), Jim and Renee and Jay and Stefanie, had such an amazing story to tell (which included five years of camping by Jim and Jay as they built the place) that I couldn’t stop talking about it.  My ranting included making a pitch to Leigh Buchanan at INC magazine, where I argued that it was more interesting than any other entrepreneurship story I had ever heard (I know her from both HBR and INC, including from her INC story on The Bully Rulebook). 

    Stefanie_and_renee
    Well, after talking on the phone to Jim and Renee, Leigh got sufficiently excited that she went down to Tranquilo Bay do a story. And she took a photographer too.  Leigh’s story just came out in the May issue of INC and it is fantastic — called Paradise The Hard Way.  It is one of the most interesting and detailed stories I have ever seen in a business magazine, more like a New Yorker story in depth and smartness (but without their at times unbearable pretension).  And it is the only story I’ve read in a business magazine that starts with an email exchange — and one is a love letter — between a husband and a wife.  The first picture is of Jim and Jay, who literally had to hack their way through the jungle to build their dream.  And the second is of Stefanie and Renee, who made considerable sacrifices to make it all happen, and now live at Tranquilo Bay with their kids. 

    The four of them now run the place. There is also a great slide show on the INC site that shows what it talk to build the place, which reminds me of a scaled down version of the story that David McCullough tells about the building of the Panama Canal in The Path Between the Seas — the rain, the mudslides, the setbacks, the improvisation,  the persistence, the shear craziness of trying to attempt something like that, and ultimately, the success in the end, run though both of these stories about Panama.   

    P.S. My family has already made reservations to go back. They only have six cabanas, so things fill-up fast!