accountability

How to Hold Each Other Accountable and Still Care

When I was young I did not do much reading. Not that I didn’t enjoy it, there was just no time for it between watching basketball on TV and playing basketball every other minute that I was awake. When I entered the fifth grade that all changed because our teacher, Mrs. Katobi was pretty clear that if you wanted to go to sixth grade that some of my time would be spent reading.

I can recall the conversation vividly. “What do you enjoy?” she asked.

“Sports, basketball mostly” I replied, bearing my entire soul to her.

“Good, find a book about a basketball player and give me a report of what you read on Monday.”

“I don’t have any books on basketball players,” I said to her thinking this would be the end of the conversation.

“Fine,” she said, “I will call your mother and tell her you need to go to the library”

And she did.

So instead of shooting hoops after school, my mother drove me to our local library.

Not only that, Mrs. Katobi had phoned ahead and told the librarian I would be looking for a book about a basketball player. The librarian escorted me over to the biography section where it seemed to me like the sheer number of books on the shelf could keep a kid from ever playing basketball or another sport ever again. Just picking one from this vast sea of paper was overwhelming.

On that fateful day in 1973, the librarian at Peoria Heights Library asked me, “Who is your favorite player?”

“Wilt the Stilt Chamberlin,” I replied, thinking no way would there be a book on Chamberlin and I would be back on the court in no time.  

She said, “Let me see. I think there is a book on him that just came in not too long ago.”

“You have got to be kidding me.” I thought to myself.

Walking over to the shelf, she pulls the autobiography, Wilt: Just Like Any Other 7-foot Black Millionaire who Lives Next Door, off the shelf.

I have always been thankful for the two main characters in this story; the librarian (I do wish I could recall her name) and Mrs. Katobi.

They knew what was best for me. They cared enough to set a high expectation (at least for a poor kid from the other side of the tracks) and held me accountable. They knew the work I needed to get done and helped me find an interesting way to do it. They did not micromanage the entire work process. Mrs. Katobi cared enough to take some roadblocks out of my way by calling both my mom and the librarian. As I reflect, this really gave me the feeling that she cared enough to make the calls on my behalf.

The bar was set for me, care and compassion were shown, and then it was up to me.

Paul Zak makes an interesting argument about this when he writes in Harvard Business Review and in Consulting Psychology Journal: Practice and Research about the powerful neurochemical oxytocin. According to Zak, colleagues who want to help each other perform better. No matter what you think about people in your organization, the decision to show up is completely voluntary. In our society, people can pretty much do whatever they want to do. Employees are not that different than people who go to church or a grocery store. They, in essence, volunteer to do whatever it is they are going to do.

Sure, in a work organization they are paid. Zak gives insight into this stating that his research shows, “they choose an organization at which to work.” It is in this realization the brain chemical oxytocin comes into play. The culture of your organization can stimulate oxytocin in your employees through all types of engagement where people feel cared for and respected. Alternately, your work environment may feel more like testosterone rules the day, causing people feel driven elsewhere to a place where they are valued and appreciated.

According to Zak, his work with oxytocin shows it is the biochemical basis for the Golden Rule. “If you treat me well, my brain will synthesize oxytocin and this will motivate me to reciprocate.”

When I shared this research, through the lens of Emotional Intelligence, with a client I am working with. He listened intently, nodded his head and said, “Yeah, but...”  In my training as a coach, I know that when I hear the word ‘but” any agreement like the head nodding and the “yeah” has just been discounted to “I DO NOT AGREE”.

Following the “yeah, but,” came “what we need to do is set clear goals and hold our associates feet to the fire to do what they say they are going to do.”

“EXACTLY” I agreed. Holding them accountable with care and compassion will have them want to engage.  

Turns out that is really not the end of the oxytocin story or my story. You see I read the book, did the report turned it in and thought that was it. Assignment finished. Let’s get back out to shooting hoops. However, Mrs. Katobi, probably being the smartest person to ever teach any subject to any student pulled a brilliant move.

“Class,” she said that next week, “I have just read the most fascinating report about a very tall basketball player and I thought you all might enjoy learning about him so, Scott, why don’t you come up and share what you learned about Wilt the Stilt.”

When I finished, they clapped.

According to Zak another big surge in Oxytocin occurs when we celebrate success. In addition, another neurochemical gets released called dopamine which among other things is the brain’s reinforcement chemical.

I wonder if Mrs. Katobi knew at that moment she was creating a lifelong, voracious reader?

How about you? Who at work do you need to show you are in empathetic agreement with? What achievement of some other person do you plan to celebrate in the near future?

Perhaps you know someone who needs to think more deeply about this idea of caring accountability? Why not forward them the link to this article and then invite them to lunch to talk about it?

Medicine, Leadership, and The Beatles

Many of you know my undergraduate degree is in pharmacy from Drake University. I worked in retail pharmacy prior to starting my career at Eli Lilly. As a result, I am naturally drawn to cutting edge stories in the field of medicine.  One that caught my eye recently in the Journal of the American Association (February, 2016) had to do with changing physician behavior when prescribing antibiotics.

Antibiotics are effective for patients only when there is a bacterial infection present. However, research into physician prescribing habits show that they are given to patients for diagnosis such as asthma, influenza, middle ear infections without pus, and viral pneumonia, (all which have an allergic or viral cause), where antibiotics are of absolutely no value to the patient.

According to a recent study by the Pew Charitable Trust, roughly 30% of all antibiotic prescriptions are for improper use, costing the health care system millions of dollars a year as a result. The reasons for overprescribing are probably numerous. I am confident no physician wakes up in the morning intending to do harm, or to do anything but practice the best medicine they know how.

So, it would seem there is a difference between the “intention” of the physician to do no harm and the actual impact of their behavior.

Leaders have misaligned intention, too.

I think many leaders are the same way. No leader gets up in the morning thinking, “You know, I wonder how I can make everyone on my team's life absolutely miserable!” (except Kevin Spacy’s character in Bad Bosses).  Here are just a few examples related to me recently:

  • A friend was telling me a story of how a leader on his team recently called out a follower in public regarding a very sensitive personal matter. This leader is now in a lot of trouble with his board of directors and will likely lose his job in the coming months.
  • A person in a training recently told me that her supervisor would not give her time off work to attend the funeral of a close family member.
  • A manager gave an associate a set of assumptions to run a market forecast. When the results came in, the manager was furious with the results, blaming the associate for not using the correct assumptions. When the associate pulled up the document with the assumptions the manager sent, the manager said the associate “misread what the manager wrote."
  • A female friend’s boss did not want to give her a deserved promotion. When her bosses supervisor intervened and promoted her, the boss actually suggested it was because she was an attractive female and had nothing to do with her skill set.

It is really hard for me to believe that leaders don’t know this kind of behavior is wrong. Yet whether we are talking about leadership or medicine, sometimes really smart people do really stupid things.

Truth is when facts converge on a central point. 

I have been realizing there is a lot of truth told in the arts. While writing this article, I realized how right John Lennon and Paul McCartney where when they wrote, “We get by with a little help from our friends,” as one of the songs done by Ringo Star on the Sargent Peppers Lonely Hearts Club Band album (just be glad this isn’t a podcast and I am not signing this to you!!!)

Perhaps we would all be a little better by practicing impulse control, and before we act, reach out to some peers and say, “Hey, I am thinking about doing [insert behavior here]. Before I do that, what do you think?"

Here is what the data from the antibiotic study says:

Dr. Daniella Meeker MD, associate professor at the Schaeffer Center for Health Policy and Economics, University of Southern California, is the lead researcher in the study I referenced earlier in JAMA. Dr. Meeker and her team set out to see if any of three different behavioral interventions would change physician behavior in prescribing antibiotics. The three actions that the researchers tested were:

  1. Suggested Alternatives - Doctors were given a list of a range of different choices they could make rather than the antibiotic they were going to prescribe.
  2. Accountable Justification - Doctors had to write a justification for the antibiotic they had written. A peer review board reads the justification and determines appropriateness.
  3. Peer Comparison - An email was sent to all the doctors in the study that compared their prescribing behavior to that of their peers. The doctors own prescribing was compared to that of top performers who’s prescribing was deemed appropriate.

Without boring you with all the statistics, the authors of the study concluded, "Among primary care practices, the use of accountable justification and peer comparison as behavioral interventions resulted in lower rates of inappropriate antibiotic prescribing for acute respiratory tract infections.” 1

Let's apply this learning to leadership.  Take the story my friend told me about a leader who called someone out in public over a sensitive personal issue.

What if, rather than calling the person out over the sensitive personal issue, the leader instead:

  1. Suggested Alternatives - The leader took time to journal some possible alternative behaviors rather than just acting impulsively in the moment.
  2. Accountable Justification - The leader had to write a justification that was submitted to a peer review board. This board then would deem the action appropriate or not.
  3. Peer Comparison - An email was sent to all the leaders in a group that documents the behavior and the leader had to see that their behavior was not aligned with top performers in their field.

No man is an island. We all suffer the consequences of our poor leadership actions.

Homework: What would it be like for you to set up one, or even all three, of the metric tools listed above. For those of you who are serious about your leadership, this is a must! At a minimum, find a peer group who can hold you accountable for actions and use them proactively in your practice of leadership.

Meeker D, Linder JA, Fox CR, et al. Effect of Behavioral Interventions on Inappropriate Antibiotic Prescribing Among Primary Care Practices: A Randomized Clinical Trial. JAMA. 2016;315(6):562-570. doi:10.1001/jama.2016.0275.