Posts Tagged Employees
Robert A. Mines, Ph.D., Chairman and Chief Psychology Officer
Thank you John Oliver and your staff for a significant public service on your show this week! Your commentary and excellent coverage of a major problem in substance use disorder and alcohol treatment will have an impact far beyond what the insurance and professional communities have been able to do.
MINES has patients who have gone out of network, received poor care, the payors have received outrageous bills, the patients are stuck with bills that can only result in medical bankruptcy and as you noted, people die in these disreputable facilities. A major component that you pointed out is patient brokering. When people Google substance abuse/use treatment, the top 20-30 are facilities, mostly in Florida and California, or are patient brokers. Reputable facilities in the person’s community do not even make the list. Then the facilities sometimes even pay the airfare to fly the patient to their facility and if the patient does not meet medical necessity for that level of care, the facility turns them out on the street to find their own way back to the state/community they live in.
You mentioned addictionologists as a resource for finding reputable care. In addition, Employee Assistance Programs as well as managed behavioral health services (insurance) are knowledgeable and informed about substance use and alcohol treatment. They know which facilities and programs are in network with the insurance and which ones do a good job.
Evidence-based treatment supports the use of a continuum of care from outpatient, intensive outpatient, partial hospitalization, residential and detox (medical and social detox). There are medications that also contribute to sobriety and health.
These are chronic illnesses/conditions that require the patients to cope with all their lives. Learning relapse prevention and adherence skills are essential.
If you decide to delve into this national problem further in a future episode, I would be happy to consult with you and your team.
The following clip may be not suitable for some work environments:
This is a link to a pdf of an article published by the Self Insurance Institute of America on predatory treatment facilities and managed behavioral healthcare strategies for helping the patients and the payors. http://www.minesandassociates.com/documents/Predatory_Facility_Article.pdf
Let’s dig a little deeper into the concept of Salutogenesis and what it might mean at your workplace.
Antonovsky’s explanation of Salutogenesis was well depicted by a river. His concern with the current model of health (Pathogenesis) is that it’s generally believed that we are healthy from the beginning but that because of environmental / circumstantial events, we become sick. Antonovsky expressed this as a river, where all healthy people stand on the bank, safe from the raging river’s flow. Once one stepped into the river – got sick – then something needed to be done. Salutogenesis, however, sees all people already in the river; but at different distances from the mouth. General resistance resources (GRRs), a term Antonovsky used as well, are the supportive mechanisms that make it possible to engage in their health generating activities. These allow for someone to swim against the current or maintain a position against the current. The result of thinking this way is the freedom to abandon the bias that one has failed at being healthy, but rather that they are always working at generating more health.
Sense of Coherence
Antonovsky’s continued his explanation of Salutogenesis as hinged on a Sense of Coherence. Sense of Coherence is defined by three major parts:
- Comprehensibility (I get this). The ability to understand one’s circumstances. If you look back at some of my previous postings on Cognitive Bias, we are unable to fully comprehend our experience because, as Kahneman has pointed out in Thinking Fast and Slow, we are subject to a number of biases including base rate neglect (not having the ability to assess, objectively, where things are from the start before making an opinion of what is possible).
- Manageability (I got this). The ability to assess resources for dealing with one’s circumstances. “The right tool for the right job” comes to mind here. To adequately meet the needs of Manageability, one must not only have the resources available, but the knowledge that they can be used.
- Meaningfulness (I’m good to go). The ability to comprehend the anticipated results as helpful. We oftentimes recognize that there is a change to be had, but taking that step can be difficult without a fire under your bottom.
Taken together, these three points sit at the nexus of the ability for any given person to be able to effectively engage with their health. When all three are maximized for performance, individuals can effectively mitigate the potential of their circumstances. Education obviously plays a big role in the process of becoming healthier, but education alone cannot make people healthier.
Your role as a benefits provider
As someone that is providing benefits to a group of people, you have a key role in the ability to help those covered to become healthier; to actually create health. It’s easy to provide a benefit that is available when it’s needed and provided by an external vendor, but that doesn’t have to be the end. Visionary organizations are engaging their population in small, but every day, ways.
What can be done
Engagement is key. First off, you have to take on an organizational wellbeing plan in earnest. If you’re willing to put in the effort, your population will be more likely to stay engaged. If you’re not behind it 100%, they probably won’t be either. But what can be done to engage in health more actively in the worksite?
Let’s look at some of the GRRs that Antonovsky identified and where they may occur in the workplace.
Money: Money enables us to purchase services and products that can enable health generating activities. It can also be used to incentivize or disincentivize activities – the so-called carrot and/or stick approach. But, money also has some significant impact on engagement. When individuals make a purchase, they are actively exchanging the value of their dollar for the value of what is being purchased. If you’re familiar with the concept of Behavioral Economics, this might include devaluation of a certain program because it is provided for free. Instead, incentivizing purchase of products or services that help in the generation of health means personal investment in its use.
Knowledge: You know that conference or meeting room that is usually set aside for meetings with clients, or teams within your organization? It may also be a great location to have a training or two related to health generating activities. Including helpful information in your break room, like healthful recipes, may be a continual reminder of what your population is putting into their bodies.
Commitment: Commitment may be especially easy to generate in the workplace because you’re already showing an investment in those you provide benefits for. Showing your commitment to the program can help create mutual investment, as well!
Social Support: Encourage people to support each other in your health generating activities by rewarding employees who provide assistance or encouragement in the health of other employees. This creates a social structure for engaging in health, and we know that community is the key to health.
Taken together, this is a powerful recipe for getting the kind of motivation needed to stay actively engaged in your population’s health. And, the long-term benefit of a healthier and happier workforce is what drives productivity and profitability.
To our health,
HR magazines everywhere cite statistics which link healthy employees to healthy workplace results. But whose responsibility is it to ensure that employees take care of their health, see their primary care physicians annually, exercise on a regular basis, eat the right foods, and get vaccinations? Although it is not the employers’ responsibility per se, there are some basic and easy ways to promote a healthy workplace which prove beneficial to both the employee and the organization.
- Promote a healthy organizational culture. There are some simple ways to do this. When ordering in meals for seminars and/or trainings, order healthy items – skip the unhealthy choices such as pizza, cookies, and chips. Involve your company in local 5ks and/or other exercise initiatives. This does more than get everyone out for some exercise; it’s the perfect environment for socializing!
- Encourage Preventative Care. This begins with offering health insurance; statistics provided by the White House show that the smaller the company, the less likely they are to offer health insurance. In fact, less than 50 percent of employers with less than ten employees offer health insurance. When selecting a health insurance company, it may be wise to ask about preventative care options such as vaccines, smoking cessation programs, and perhaps annual exams without charge. Be sure to advertise these benefits to your employees, encourage them to get physicals, and consider offering them time during the workday for preventative care (The White House, 2009).
- Consider Incentive Programs. Incentive programs in organizations are growing all over the United States. Programs that encourage employees to exercise, attend regular doctor appointments, get vaccinations, eat well, and overall take care of themselves have really jumped in popularity. Some incentives to consider may include bonuses, awards when they reach their goals such as certificates or fitness gear, and overall continued encouragement for the effort in which they put in!
Daniél Kimlinger, MHA, PHR
Human Resources Specialist
The Economic Effects of Health Care Reform on Small Businesses and Their Employees. The White House (2009, June 25). Retrieved August 22, 2011, from http://www.whitehouse.gov/assets/documents/CEA-smallbusiness-july24.pdf
Elliott Jaques defined the accountability of a manager as the person responsible for providing adequate systems for the supervisors and front line employees to be able to do their job to the best of their ability. Everyday, we get to consult, weigh in, design, or support employees who work with incompatible systems: data bases that do not talk to each other and require work arounds, work flows that bog down due to contraints that bottle-neck the work flow, and individuals who hoard information and dole it out sparingly as examples.
The cost to the organization and the individual employees is significant. The costs are incurred in increased payroll, individual psychological and physical distress, turnover, absenteeism, or apathy and indifference.
Often, the organization either: has not done adequate captial allocation planning for operations systems at the facility, plant, or hardware/software levels; has “done it this way for so long” that managers and employees have forgotten (usually due to banging their head against wall too many times in frustration) to question their assumptions on a regular basis; or the manager does not have the cognitive complexity (strata 3 or above in Jaques’ model) to be able to think systemically as well as other factors beyond the scope of this blog.
Dan Segal defined a system as an integrated flow of information and energy. How are your systems functioning? If not optimally, what and when are you going to do something about it so your organizational and individual employee performance is improved?
Have a day filled with integration,
Robert A. Mines, Ph.D.
CEO & Psychologist
MINES’ communication theme for July is “Fortifying the Family.” For BizPsych, this theme in particular brings up some fascinating thoughts regarding organizations and organizational development/business psychology. Many of our clients like to think of their businesses or their teams as a “family.” Typically this is when things are going well or were in the past – “we used to be like a family.” I suppose that means that when things are not going well it is like a dysfunctional family, although since none of us really want to associate with that we tend to say “we are no longer like a family,” or “we have lost the family atmosphere.” Even in these references it is clear that a business may feel like a family, but is not a family. In this post, I would like to explore some of the important differences and similarities between family and business.
First, what are the essential differences between family and business? Here is a quote from The Family Business Magazine (Summer 2011 issue):
“… families by definition are the bearers of legacy. Their mandate is to perpetuate and teach familial characteristics – beliefs, morals, assumptions, standards, history, trauma, intimacies, triumphs and failures of past generations. The difficulty lies in the dissonance between these characteristics and what is required for success in the business world.”
The current Wikipedia definition of “business” is as follows:
“A business (also known as enterprise or firm) is an organization engaged in the trade of goods, services, or both to consumers. Businesses are predominant in capitalist economies, in which most of them are privately owned and administered to earn profit to increase the wealth of their owners. Businesses may also be not-for-profit or state-owned. A business owned by multiple individuals may be referred to as a company, although that term also has a more precise meaning.”
These are vastly different basic foundations. What is the mission or purpose in a family as opposed to the mission of a business or organization? In my view, a healthy family provides support to each individual within the context and relationship to the roots and primary environment of that individual. One of the essential purposes of the family is to create a bond and environment that supports the success of the individual and helps perpetuate a legacy to the future. In the case of a business or organization the primary purpose is to foster the success of the business in meeting the need of its clients or customers. The ultimate goal of the business may be to make profit, or in the case of nonprofits, to maintain and grow the capacity to serve the needs of its clients and the community.
This essential difference leads to what is targeted as a primary difference between family and business and that is the principle of loyalty. Interestingly enough, this is a principle that has shifted significantly in business in the last thirty years. It has become evident that businesses cannot and do not maintain loyalty to its members (i.e. staff) at the expense of the “bottom line.”
“But saying your business is like a family raises expectations that most companies are unwilling to meet. As former New York Knicks coach and basketball commentator Jeff Van Gundy told the New York Times concerning the rash of NBA coaches already fired this season: “It’s always intriguing to me that everyone preaches we’re all in this together, we’re a family. The difference is we are in this together only when it’s going good.” (Fredric Paul InformationWeek December 17, 2008 05:05 AM).
One of the first things families do when they bring a child into the world is to sacrifice one of their most precious assets i.e. sleep for the benefit of their newborn. That is loyalty. The marriage contract typically asserts, “in sickness and in health… till death do us part.” Families stick together “through thick and thin.” Of course this is not always nor should always be the case. Couples divorce, family members become estranged, and teenagers sometimes get “kicked out of the house.” However, this is typically not because of lowered productivity, substandard performance, or to maintain profit margins. We have recognized that in many cases maintaining loyalty over excellent performance can be extremely damaging to business and the organization. Often times in families, loyalty over performance yields positive results for both the individual and family system.
Then there is the middle ground i.e. family business. Much has been written on this topic as well. Several of my consultant friends specialize in family business consulting. Herein may lay the key to understanding some of the essential differences. Typically the articles on this subject differentiate private business from family business. Here are some of the differentiating characteristics that have been identified between family business and “private business:”
- Different Goals: Many times small business owners may have different goals other than their company’s success. There may be certain charities which the owner feels strongly about, but, cost the company more than it can afford. Publicly owned companies are not in position to do this, because of legal reasons, and negative criticism that they will receive.
- Nepotism: Sometimes the owners of family businesses feel an obligation to hire family members rather than hire someone else who may have better credentials. This causes many problems, and can even cause a company to go out of business. There are sometimes fights within the family.
- Less Profit Margins: Public companies have an easier time producing mass number of items, and thus they can get larger profit margins. Mostly the profit margins are twice as large in public companies.
- Less Care about Profits: Many small business owners, specifically family businesses, have a tendency to search for non financial things. They often try to do things that don’t bring profits to the company. They will often try to lower their price to make there customers happy, even though they can’t afford to do so which is not the right business strategy.” (John Elton Article from articlesbase.com)
The article goes on to identify some of the strengths of family-owned businesses:
Strengths of family-owned businesses:
- Teamwork: In family businesses members don’t doubt other’s intentions because they are related, and thus working for a common purpose. In public companies however they may try to do things that hurt others in order to get ahead and gain promotion.
- Greater Sacrifice: In family businesses family members are often willing to work longer hours with efforts for less pay, because they know that they are doing it for the family, and that they are making the company stronger for their kids and grand kids.
- Loyalty: In family businesses it is rare to find turnover, specifically in management, which makes it easy to keep employees for a long period of time, who know what they are doing. In non family businesses employees/managers will often go to a different company for better services and salary and may start off their own company in direct competition to yours. Even if a family member does decide to quit their job, it is very unlikely that they will compete against you.
- More Concerned Employees: In small family businesses the employees are concerned about their company’s success rather than their own success. In public companies the employees often just expect to work for a 40 hour workweek, and then go home, not thinking about their job until when they go back the next Monday. The commitment difference is seen from this.
It is necessary that small businesses recognize their strengths and weaknesses so that they are able to move in the right direction. (John Elton Article from articlesbase.com)
In sum, there are many essential differences between a “healthy family” and a “healthy business.” It is important to keep these essential differences in mind lest we create expectations that are not realistic or helpful to the business (or to the family for that matter). It is also important to recognize some of the similarities and characteristics that are constructive in both families and business.
Consider these tips for communicating with aging parents from ones of MINES’ July newsletters: (Source: Parlay International ©2010 from MINES and Associates’ July 12, 2011 Weekly Communication)
- Set aside appropriate times to talk
- Talk about one thing at a time
- Equal time for talking and listening
- Avoid blame
- Avoid exaggerations
- Focus on problems and solutions
Hmmm, this is an article about family, but seems to identify some of the communication tips we often share with managers and employees in business. Seems it pays to be mindful of both the similarities and differences between family and business – whether private, public, or family-owned.
Patrick Hiester, MA, LPC
Vice President, BizPsych
“My son has a fever and needs to stay home and rest.”
“I just had surgery and can’t sit for long periods of time.”
“It doesn’t make sense for me to work and pay for infant daycare!”
Do any of these issues come up in your company? If you think that they are stressful for the organization, just imagine the burden on your employees. One option that is grasping more and more attention is allowing employees to telework if they as employees, and their positions, permit it (Heathfield, 2011).
So, how would an organization determine whether or not a position is a strong fit for telecommuting? There’s no simple answer but here are some variables to consider (Heathfield, 2011):
- The position must be able to be completed outside of the office building. There are some new and creative ways to make this possible, even for those positions that seemingly need to be completed in the office. One such position is a call center employee — many companies are offering their employees remote access and soft phones on their computers.
- The employees should be able to work independently inside of the company in order to be considered for telecommuting.
- The employee and the manager should both be comfortable with electronic communication, i.e. e-mail.
- The employee should not be wearing the “home” hat and the “work” hat during their working hours. The employee should have uninterrupted work time at home.
- The employee must be trustworthy.
Daniél C. Kimlinger, MHA, PHR
Human Resources Specialist
Heathfield, S. (n.d.). Life and Family Challenges With Flexible Work Schedules? In About Human Resources. Retrieved June 21, 2011, from http://humanresources.about.com/od/workschedules/f/life_family.htm