Friday, September 24, 2010

The Boss Leads The Way

Linda Hudson, CEO of BAE Systems, got this message after becoming the first female president of General Dynamics. After her first day on the job, a dozen women in her office imitated how she tied her scarf. Hudson realized, “It really was now about me and the context of setting the tone for the organization. That was a lesson I have never forgotten—that as a leader, people are looking at you in a way that you could not have imagined in other roles.” Hudson added that such scrutiny and the consequent responsibility is “something that I think about virtually every day.”

This snippet above illustrates the importance of the CEO in setting cultural overtones for a hospital. In short, if you are looking out the window of your executive office and wondering why it is that people dont do things they way you would expect them to do them - then it is because they are following your lead.

Now let's be realistic. We're not talking about how people go about giving an injection, applying a bandage, cooking a meal or preparing a set of financial accounts. These are technical skills, these are taught skills. We're talking about the behaviours that make an organisation an enjoyable place to work, or otherwise.

What are your surveys telling you? Do you even take any notice off the picture they paint? Maybe you do and maybe that is why you are feeling a bit disappointed. I hope so. Now turn around, find a mirror and look into it. What do you see? Do you see a CEO who smiles, has a open, inviting posture, looks interested in other people, has a enquiring mind? Do you see someone who wants to help, wants to engage everyone in the organisation? If you were new to your organisation and you were looking at you on your first day, would you want to follow yourself?

Now the challenge is that what we see in ourselves and what others see will often be different. It is a rare individual that is able to undertake an accurate self assessment, and more importantly, make the changes without being pushed into doing so by someone else or some form of crisis. By that stage it is often to late and we are left wondering what it is we did wrong.

When you arrive in the CEO's office, newly minted, or any senior executive office for that matter, life does change. For a start you have immense influence over the careers of other people. In turn they have less influence over yours. This is an outcome of our hierarchial system of management. It can be different but not likely to be in the current climate. Those that you have influence over begin to observe you from day one. They note constantly every aspect of your behaviour, and they copy whatever they believe will help them to advance or remain in their role. This is natural behaviour. We prefer the status quo to something different and we do everything in our power to retain the status quo - to the point of going down with a sinking ship because our perception is that this is the least risky option.

If you decide that decision making will be a solitary exercise, take a heroic CEO stance, where you appear to know it all - then that is exactly the stance your senior executives will take. Those that are uncomfortable with that style will eventually leave and you will likely replace them with people similar to yourself. In turn, every manager throughout your organisation will adapt that style of decision making. In this instance the outcomes could be catastropic. This eventually leads to a culture of blame and backside protecting. Who would you blame? Yourself or your management team? I would suggest you start by looking at yourself.

How do you stop this from occuring? Firstly ask yourself, are you open to change, are adaptable, are you willing to listen to feedback from others, and if so are you prepared to act upon that feedback? If not, its time to go home. It's time to find another role. Let the Board appoint someone that is adaptable and able to work with people, able to engage with people and able to listen to what other people say.

Should you decide you have all the good qualities! Then it is time to seek some feedback, formally or informally it doesn't matter. What is more important is what you do with the feedback you receieve. Try this, speak to those that gave the feedback. Thank them, do not criticise their feedback. Have a conversation, seek more information and make a commitment to ongoing change. Ask for their support and feedback. Seek some executive coaching or mentoring. An external coach, with no political affiliation, no axe to grind, whose only desire is to see you be the best you can be, can also help you to challenge your assumptions, interpret your observations and develop new management behaviours.

When you seek feedback, go deep into your organisation. Many CEO's limit feedback to immediate direct reports in the executive team. Remember what was stated earlier about focusing on those with the greatest impact upon your career. Maybe the people with the most to lose are not the most reliable when it comes to getting feedback on your behaviour as a CEO. Afterall they are simply copying you. What would they see wrong in your behaviour?

Other people will see a different CEO. They will focus on the impact you have upon them. They will look at how you communicate with people, how you share information, how you engage them and seek input from them. They will judge you upon the quality of people you promote into management roles. Yes they will gripe about how little they are paid and how difficult their work is. You need to hear these things also. You need the reality check. Some things you can do something about, others you can do nothing more than listen. You will be judged upon how often and how well you listen. You will be judged upon how often rank and file staff see you in their territory, and when you are there, they will judge you on how you behaved towards them and their colleagues.

This will not be easy feedback to seek, to listen to, to absorb or to act upon. CEO's and senior executives assume a persona when you reach higher office. Its a coping strategy for all the issues they are faced with on a daily basis. It helps to protect them from the constant demands upon their time. It can also prevent them from being perceived as a real person, someone with heart and soul. Noone will doubt you have a brain; yet often they will doubt you know how to use it.

Becoming a CEO does not mean you know it all. It does not mean you have reached the pinnacle of management behaviour. It does mean you are at the beginning of the next stage of your journey, rather than the end of the journey.

Let The Journey Continue
John Coxon

Taking You From Frontline Manager to CEO

Telephone: +61 247 390 376
Twitter: john_coxon
Facebook: johncoxon1

Friday, September 10, 2010

Indian Healthcare Leads Employment Growth

In 2009 there were approximately 8400 Indian nationals working in Australia on temporary visas, with a significant number, if not the majority involved in the healthcare sector. An increasing number of Indian nationals work as nurses in Australian hospitals. Why is this? Because Australia is facing a severe shortage of labour in all sectors, including healthcare. This is not going to change in the next two decades, which means that if the Australian health sector is to continue to meet its performance targets then it will need to (a) attract more Australian qualified medical practitioners back into the sector, particularly registered nurses or (b) allow a greater number of immigrants to work in the sector.

Now here's the rub. India is an emerging nation. Its health sector has recorded annual growth of around 8-9% per annum in recent years, in line with sector growth of other emerging nations. A report into the Indian healthcare sector by India Brand Equity Foundation predicted the Indian health care sector will grow to US$280B by 2020. Biz India on their facebook page recently reported that India will generate almost 300,000 new jobs in healthcare in the next twelve months and increasing over the next few years. This is a nation that will need every healthcare worker it can get and increasingly it will become easier for Indian nationals to remain in India or return there to work in the Indian health sector.

The impact on Australia, and other Western nations that currently 'import' Indian nationals to work in their hospitals and general practices will be significant. They simply will not have sufficient numbers of people working in healthcare or prepared to enter the sector. The impact will be felt in many areas. Service delivery can only be fully delivered when there are sufficient people to do so. Where there are insufficient people in the sector, service delivery will be rationalised. This will impact mostly in rural and remote areas. Competition for health care workers will increase and this will force an increase in salaries and other benefits. This will be good for those involved in personal carer roles which are often at the bottom of the food chain. The problem is that within the public sector the money for paying labour is provided by Government from general taxation. As the population ages, the tax base reduces and thus there is less money available for funding healthcare at a time when the demand for service is greatest.

As the cost of labour increases so does the cost of service delivery. This creates greater rationing of services in the public sector as hospital managers strive to maintain service delivery costs within budgets. In the private sector it contributes to increase in the gap between health cost and health insurance cover. In both instances the cost is incurred by the taxpayer through increased costs and longer waiting lists. A headache for policy makers seeking to appease voters.

Which brings us to medical tourism. India is an English speaking nation, based upon democratic principals, leaving aside sectarial differences, much of its key health care facilities are high quality and many medical professionals are trained to Western nation standards - and they operate from a lower cost base.

Already thirteen Indian hospitals are accredited with Joint Commission International (JCI), the largest healthcare accrediation agency in the USA. In 2009 almost 500,000 visitors travelled to India for medical treatment, only 50% less than the number travelling to Thailand for the same reason and slightly more than travelled to Singapore. More than 50 Indian hospitals are currently undergoing accreditation with India's National Accreditation Board for Hospitals and Healthcare.

Those that are most likely to travel overseas for treatment are those with high incomes and without private health cover or those with health cover and a high gap