While in college, I agreed to meet someone at our church. No one else was at the building. It was 1:30 in the afternoon. I was able to let myself in, because I had a calling that required me to have a key. As I think back on it, I cannot remember who I was meeting or why; I just remember that this person stood me up. I sat for an hour in the foyer. Staring out at a gray, rainy sky, I thought, “What a miserable day!” I lived in Monroe, Louisiana where we would get a lot of rain. If every rainy day was a miserable day, I was going to have a lot of miserable days. I chose then to look for the beauty in that day. Everything looked clean and shiny from the standing water. I appreciated the different shades of gray. I saw bright sunlight peeking out through the clouds. I beheld that it really was a beautiful day, and my mood lightened considerably.

Frederick Longbridge said, “Two men look out through the same bars. One sees the mud and the other the stars.” Both are incarcerated. Both are in a bad place, yet one sees hope, and the other sees despair. One sees beauty and the other ugliness. Many people feel trapped in their lives, their work and their circumstances. They see so much of what is wrong and so little of the beauty that surrounds them.

The lens of seeing the good can be a powerful tool for anyone and especially for a leader. When we look for the good in people, we will find it. When those we lead know that we see good in them, they feel valued and respected. They want to prove that our faith in them is well-placed. They will often rise to meet our expectations. If we find concerns in their performance, we are able to weigh those concerns against all they bring to the table. We would not so blind our eyes to tolerate any kind of bad behavior. There must be accountability. Yet a strong tendency to look for the good is more likely to be right and to be effective in leadership than a strong tendency to look for the bad.

When we face great challenges in our organizations, we may see them as an opportunity to survive or perish. We should remember that the great men of history are made or revealed by the great challenges that have been thrust upon them or they have imposed upon themselves. Winston Churchill found his place in history because he was prime minister in England’s darkest hour and rose to meet the challenge.

In the movie, The Fellowship of the Ring, Frodo says: “I wish the Ring had never come to me. I wish none of this had happened.” Gandalf answers him saying, “So do all who live to see such times, but that is not for them to decide. All we have to decide is what to do with the time that is given to us. There are other forces at work in this world, Frodo, besides the will of evil.” Most organizations are faced with serious threats. We must not see these as our doom. These are beautiful opportunities to rise to greatness as leaders.

My own Christian faith is the source of my next thought on beauty. It occurs to me that Jesus Christ must see each of us as beautiful. I am certain that there are some expressions that He is not pleased to see, but I do not believe that He sees any of us is ugly. So, what makes us beautiful to Him? To answer that question, I want to take you to an assisted living facility in Rochester, New York.

It was the Christmas season. We had gone as a family to visit a beautiful, octogenarian couple we knew from church. We had with us three-year-old Abigail and infant Michael. Small children get a lot of attention in assisted living facilities. As we were leaving, we were invited into a public room that had the feel of a living room. In this exchange of laughter and joy, I captured with my camera a remarkable image of Abigail standing in front of a very old woman holding her chin with the tips of the fingers of her upturned hand. Each gazed on the other with a look of pure love. As I have studied the picture, it occurred to me that Abigail only saw beauty. I thought about all the grandparents and great-grandparents all over the world, many of whom are quite weathered and withered with age who are adored and are seen as beautiful by their perfect grand and great-grandchildren.

I am sure that you have known where I was going with this. We are seen as beautiful by Jesus Christ, because he loves us. This has caused me to realize that if I ever see someone as ugly, it tells me far more about where my heart is and should not be than it does about the other person. When we love people, they are beautiful to us.

So, a true understanding of beauty has brought us to love. The kind of love that I am speaking of is philia or brotherly (or sisterly) love. When we truly love, we cannot abuse. We seek the interests of others. We are as merciful as circumstances can allow. If hard choices must be made, we implement them as softly as possible. Love is one of the great and essential leadership qualities. Our ability to see beauty is a powerful indicator of our mastery of that love.

someone in their 80s

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The first time that I ever gave much thought to linking my choice of car to my career was in my medical legal class at Louisiana State University School of Medicine in Shreveport. We were warned that a disgruntled patient might see our expensive new Mercedes-Benz in the doctors’ parking lot and decide that we deserve to be sued. I cannot tell you exactly which car you should buy as a leader. That will vary according to your community, your personal needs, your personality and your important stakeholders. In this article I will illustrate how your choice of automobile might strengthen or weaken your position as a leader.

For two years a man that I know had the contract to do all of the electrical work in a large manufacturing plant. He bought a four-year-old, $40,000 Porsche and drove it over to the plant. The engineers in the plant took one look at the car and said, “He is making way too much money off of us,” and canceled his contract. He could have spent the same amount of money on a new pickup truck and they would have been fine with it. The problem was not the amount of money that he spent, but the brand image of the car he chose. One man told about owning an old Audi. He said the car was in rough condition, and he had not paid much money for it, but every time someone got in the car they would say, “Oooh, an Audi!” The brand image had overpowered the age, poor condition and low resale value of the actual car.

We often covet automobiles with high brand images that project the message that we are wealthy, successful and of a high socioeconomic class. There are situations where that message may serve our purposes well. A friend of mine was a senior executive at a Fortune 500 company. He drove an old, red Ford Ranger pickup truck. Functionally, it served his needs quite well, but one evening he valet parked it at an expensive restaurant where he was having dinner with other senior executives including his boss. After the dinner the valet brought his beat-up pickup truck around for him. His boss began to speculate over what clown would have driven that piece of junk to the restaurant. Since the valet was waiting for my friend to get into the truck, he had to confess to his boss that it was his. His boss told him, “You need to buy yourself some class.” And he did. He bought a beautiful, brand-new luxury car. Perhaps that was necessary to dig himself out of the hole. If he had not been in the hole to begin with, he would’ve done just fine with a clean, late-model Toyota Camry, Toyota Avalon or Honda Accord. My friend’s stakeholders were all other well-paid senior executives who drove expensive cars.

Sam Walton had a different set of stakeholders - his employees and his customers. These are all working-class people. He drove a 1979 Ford F150 single cab pickup truck. He said, “I just don’t believe a big showy lifestyle is appropriate. Why do I drive a pickup truck? What am I supposed to haul my dogs around in, a Rolls Royce?” Sam Walton was like the self-made millionaires described by Thomas Stanley in his book, The Millionaire Next Door, only he was the billionaire next door. He used his truck to great effect to project the image that he wanted his employees and customers to see. It was powerful because, in spite of all his acquired wealth, he was still that man.

He reminds me of my late friend, Bert “Nevada” Smith, from Ogden, Utah. He had only an 8th grade education and was one of the smartest men I have ever known. He grew very wealthy buying and selling military surplus, farm supplies and land. He offered to partner with me on business deals. I declined because my path was set on medicine. I have never been sure I made the right decision. One day he was taking me over to look at a surplus pickup truck. We walked out to his truck. It was an older Chevrolet single cab four-wheel-drive pickup truck. I made a point of looking at the odometer. It had over 70,000 miles on it. It was clearly a work truck. Bert dressed nice, but not above his customers. Everyone knew that he was wealthy, yet he was one of them.

My internal medicine residency program took me to Kijabi, Kenya, in October 2002 for a tropical medicine rotation. Kijabi Station is a ministry which includes a church, a hospital, a boarding school for ex-patriot children and a school for the local children. The wife and mother of one of the families ministering there shared with us that it was not their hiring several local people to be nanny, housekeeper and landscaper that caused distance between them and the local people, but the fact that they owned any car at all. In America, hiring “servants” to help you around the house is considered pretentious and selfish. In their local culture, you would be considered selfish if you did any work that you could afford to pay someone else to do. But since so few people owned cars in that area, there was no escaping that you were of a different class if you owned one.

Years ago, I spoke to a wealthy man who had been called to a high-level, unpaid ministry position in my church. He told me that when he was first called to this position that he owned a Mercedes-Benz. He discovered that the brand image of that car caused a division between him and the people he was called to serve so he sold the car and bought a brand-new, fully-loaded Suburban. He paid almost as much for the Suburban as he got for the Mercedes-Benz, but the brand image of the Suburban was a fit for the people he served, and the Mercedes-Benz was not.

I attended a physician leadership conference at a beautiful, high-rise hotel on the beach in Miami. I was in a shuttle van on my way back to the airport. As we moved through the parking lot of the hotel, two other physician leaders zeroed in on a beautiful, exotic sportscar. They both really wanted that car. I tried to caution them of the baggage that the brand image could bring to their leadership roles. I invited them to consider how difficult it would be to negotiate effectively against a union asking for pay raises for employees that their organization could not afford if it were known that they were driving that car. Their response seemed to be, “To heck with the consequences. We just want that car.”

It is possible that you may serve your entire tenure in an important leadership position without anyone taking any special notice of the car you drive. This is more likely to occur if you choose an automobile in the middle of the spectrum, neither too low-end nor too high-end. Remember, especially on the high-end, that the actual value of the automobile may not be what drives people’s impressions, but the brand image of car you choose. Instead, select an automobile that will not distract, but complement and strengthen your position as a leader.

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Mark Twain said, “Eat a live frog first thing in the morning and nothing worse will happen to you the rest of the day.” When I first read this quote, I thought it was just a bit of silliness and good fun, but I read once that it meant that you should tackle your most dreaded task first. This is good advice for often dreaded tasks are not as difficult as we feared. We just need to get started.

My long-range calendar is kept in Outlook, but I do not use Outlook to keep track of what I need to do today. I have often found myself ranging over the hospital so I would not have immediate access to my desktop computer. I also want to be able to talk on my phone and look at my schedule at the same time. So, to prepare for tomorrow, I pull out an unlined 3 x 5 index file card. Orienting it in a portrait layout, I write the day of the week and the date at the top. Below this I write in my known schedule for the day. If meetings are back to back, I write them with no space in between. If I have time between meetings, I leave space to write in commitments that will be made that day.

If you have a job with clear and regular boundaries between work and personal time, it may be practical to keep two separate calendars. But those of us in leadership, especially hospital leadership, find the boundary between work and personal time to be very fluid. We may have to come in early one day to meet with the surgeons and the next day stay a couple of hours into the evening for hospital committee meetings. Under these circumstances, it is critical that there only be one calendar on which is kept all work and personal commitments. One of Steve Jobs’ daughters understood this principle well. When her father would commit to spend time with her, she would call his secretary and have her add the event to his calendar.

If someone helps you with your schedule, it may be necessary to give them access to your Outlook calendar so that they can schedule meetings for you. If you feel you need privacy, it is possible to add things to your Outlook calendar such that others can see that the time is blocked but cannot see how you labeled the event.

On the backside of the 3 x 5 index file card, I write my “to do” list. These are things that I want to get done in my open time between meetings. As things are completed, I cross them off. Anything uncompleted by the end of the day, can be added to the next day’s “to do” list. For me there is always something to carry over on my “to do” list to the next day for I am a very ambitious “to do” list writer.

So how do we prioritize our “to do” list? We can begin by looking at our list in terms of a Johari window. Tasks can be divided into urgent & important, not urgent & important, urgent & not important and not urgent & not important. We must be careful about how we characterize our tasks. We may think that something is not important, but we can make a serious mistake if we decide that a task in unimportant while our boss thinks it is extremely important. We can lighten our load and focus our energies by removing things that are truly not important from our “to do” list. In the short term we must tackle urgent and important tasks, but in the long run we want to complete our tasks that are important while they are still not urgent.

There is merit in quickly knocking out easy tasks that are important, but we must not allow our sense of accomplishment to excuse us from tackling difficult tasks that we need to get done.

No is a word that I do not like to say to my superiors. I was hired to make things happen and to get things done. I was hired to be a solution to problems. When given a problem, I want to serve, I want to help. This can result in overloading my schedule. After starting a job as a physician leader, I was invited to sit on several committees. Early on I was given advice by one of my bosses that I should limit the number of committees that I sat on. So, I asked him to give me a number of how many committees he thought I should be on. As I accepted these committee assignments, I let them know that I had a limited number of committees that I could be on and that I might have to step down from their committee if the hospital needed me somewhere else. I had the advantage that I oversaw 22 physicians and four nurse practitioners who each needed to sit on at least two hospital committees. With so many providers needing committees, I struggled to find places for them all. When I needed to step down from one committee to take on a more important assignment, I was always able to replace myself with one of these providers.

Stephen Covey listed “sharpen your saw” as one the seven habits of highly successful people. A carpenter who only saws and never takes the time to sharpen his blade will be very unproductive sawing with a dull blade. We must take time to plan, prioritize and organize our work. This gives our work focus and power. We feel more effective, because we are more effective, and that sense of accomplishment brings joy and meaning to our work.

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“The obstacle is the path” is a Zen proverb that tells us that obstacles are the key to success.

Sometimes the only way out is through. The key to overcoming adversity is at times simple perseverance. Winston Churchill said, “If you’re going through hell, keep going.” Churchill was surrounded by people who, early in World War II, wanted him to give in to Hitler. He would not surrender. If he had, the world would be a very different place today.

Adversity gives us strength. Great athletes must challenge their bodies to develop the strength, skill and agility needed to excel. My mother is fond of quoting Ralph Waldo Emerson who said, “That which we persist in doing becomes easier, not that the nature of the task has changed, but our ability to do has increased.” The Russians are the masters of extended times in space. These cosmonauts were able to spend many months in the apparent weightlessness of space free of the constraints of gravity, but when they landed on the steppes of Kazakhstan, they had to be carried away on stretchers. They had lost so much bone and muscle mass that they could no longer stand.

In entrepreneurship, we are taught that the key to innovation is the “pain”. The pain is the problem that your innovation solves. If there is no pain, no problem, then there is no need for your innovation. Many entrepreneurs developed innovations that made them very successful when they found that the marketplace did not offer a solution to their own problem. They knew that others would value their solution if available so they offered a product or service to solve the same problem for others. Read Full Article.

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Photo Credit: Jeff Widener, Associated Press

Years ago, my sister taught a Sunday School class of 5-year old boys. At 11 p.m. one Saturday she suddenly remembered that she had a schedule conflict and needed me to teach her class. I got up early the next morning to study the lesson and to cut out and color smiley faces. As the time for church neared, I gathered all my materials and headed for the door. I suddenly remembered that my sister had told me to take them a snack, but a quick glance at the clock told me I was out of time. If I did not leave then, I would be late for church.

About halfway through the hour-long lesson Daniel suddenly became concerned. He looked and sounded like a little man dressed in his navy-blue business suit with white shirt and tie, “Do you have a snack for us?”

“No, Daniel, I ran out of time while preparing the lesson. I am sorry. There will not be a snack today.”

Daniel folded his arms and crossed one leg over the other. He gave me a look of stern disapproval and in an even, authoritarian tone stated, “Our teacher ALWAYS has a snack for us.”

“Daniel, I am sorry, but I do not have a snack. I did not have time.”

Daniel looked at me like a boss who was not going to accept excuses. “You are not a very good teacher.” Another little boy sounding very much like “a little boy” said, “Yeah, you’re not a very good teacher.”

And in that moment, I knew that Daniel had taught me a very important lesson.[i] I thought to be a good teacher I needed to know my lesson and color and cut out smiley faces, but Daniel knew that the most important key to being a good teacher was to bring snacks, and if Daniel was my boss, and I did not bring snacks, I was not going to get a good performance review. Read Full Article.

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In an industry where its competitors have frequently gotten into serious financial difficulty, Southwest Airlines has maintained profitability every year for the previous 45 years. This is an amazing accomplishment. We will explore some of the strategies that Southwest Airlines has used to drive that success.

Southwest Airlines has only ever flown one type of airplane, Boeing 737’s. All its pilots, flight attendants, ground crews and mechanics are trained to work with every plane Southwest owns. Southwest must maintain a parts inventory for only one type of plane. I see two lessons to be learned from the strategy. The first is the value of simplicity. The second is the importance of sticking to your strategy. I am sure that over the years they were tempted at times to buy smaller planes to service smaller markets and to buy bigger planes to service foreign markets. Southwest did not yield to the siren call of chasing every potential customer. They would only pursue those customers who fit within their business model.

Southwest Airlines does not believe that the customer is always right. The late Herb Kelleher, former CEO of Southwest Airlines, said that the customer is not always right. “And I think that’s one of the biggest betrayals of employees a boss can possibly commit. The customer is sometimes wrong. We don’t carry those sorts of customers. We write to them and say, ‘Fly somebody else. Don’t abuse our people.’” So, what does this approach do for Southwest’s customer service? My own experience is that Southwest employees have always been warm and gracious to my family and me. But for more objective evidence we will look at the Temkin Experience Ratings. Southwest has rated number one for customer experience among US airlines every year since 2011 except for 2015. Read Full Article.

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My father taught us, “If you want to be happy, simplify, simplify, simplify.” He loved the quote from the movie, Amadeus, in which the Austrian emperor told Mozart that his music had “too many notes.” My father did not agree with the criticism of Mozart’s music, but felt the quote was great for describing anything from cluttered architecture and art to overly complex solutions to problems. His house that he built from steel is pictured with this article. It is an expression of his design and artistic philosophy: clean, smooth, uncluttered, simple lines.

Albert Einstein said, “The definition of genius is taking the complex and making it simple.” Steve Jobs surely met this definition as he brought us the power and complexity of computing through as simple a user interface as possible. He took the complex and made it simple.

We often find that we cannot complete all of the tasks that are already on our “to do” lists let alone other tasks and goals we should be adding. We can choose what is most important to us and drop some good things from our list that are standing in the way of our accomplishing better. Advice I received from the book, Scrum: The Art of Doing Twice the Work in Half the Time by Jeff Sutherland and JJ Sutherland, helped a lot. Give yourself a short deadline. I needed to write an application to the Texas Medical Board to start a hospitalist fellowship. It seemed to me like this should take several weeks to complete which I did not have so I kept pushing it down on my to do list. I gave one of my hospitalists and me two hours to complete the application. We were done, and the application was accepted. My inner OCD wanted to overly complicate the task. I needed to simplify. Read Full Article.

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Reactive vs Proactive Leadership

I do a lot of reading on leadership. About 2 years ago, I read a book in which the author briefly contrasted reactive and proactive leaders. The author said that reactive leader does not seem to anticipate problems and does not see them coming until they are blowing up in his face. The reactive leader is constantly putting out fires. The proactive leader on the other hand sees problems just as they are starting to grow, or even before they begin, and calmly takes quiet and gentle steps to correct and avert so that the conflicts and disruptions are minimized or even completely prevented.

A reactive leader may be confronted with ugly contentions for any combination of the following reasons:

1. Does not see the problem or consider that it might develop.
2. Sees the potential problem, but does not want to be bothered over something that “might” happen.
3. Sees the problem, but is afraid to act.
4. Created the problem by misguided attempts to solve other problems.
5. Enjoys contention and creates problems in part to create sparring opportunities or opportunities to assert dominance that are ego driven rather than leadership required.

The proactive leader does as Walter Gretzsky did and skates “to where the puck is going, not where it has been.” He has an eye to future disruptions. He sees the problems and is ready, willing and unafraid to act. He does not shy away from healthy conflict resolution, but prevents or minimizes unhealthy contention within his organization. He may disrupt his organization to move it where it needs to be to survive and thrive, but he will not allow his organization to be disrupted to no purpose.

I recently read an online article that presented reactive and proactive leaders as two equally valid leadership styles.ⁱ The reactive leader is presented in this article as strong in the surprise conflict, but weak in anticipatory leadership and the proactive leader as strong in long-range planning, but weak when called upon to “shoot from the hip.” I could not disagree more. A reactive leader is responding to whatever hits him and cannot have a firm hand on the tiller of the organization. For the proactive leader, the ability to extrapolate likely future scenarios and to predict human nature and act with vision and foresight does not make one unable to act upon the present urgencies and emergencies. Indeed, a proactive leader who has an eye to the future will be able to craft acute conflict resolution that is long lasting and strengthening to the organization.

Now, here is the part that stuns me, yet I have seen time and time to be true. This unknown author says that the reactive leader is often seen as the stronger leader, because he is often seen with guns blazing at a terrible dragon he is slaying for the organization, even if he is the one who fed and nurtured that dragon. The proactive leader is too often seen as weak or irrelevant. Why is he even needed? The organization seems to run itself. He often addresses problems discretely allowing key stakeholders to save face in front of the rest of the organization while bringing them effectively back on track. So much of what he does is unseen so it is assumed that it is not happening.

ⁱPROACTIVE OR REACTIVE LEADERSHIP, WHICH IS MOST EFFECTIVE IN THE WORKPLACE? VICKY BAILEY, 2016-12-02

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A physician who I greatly admire and respect once took a job as a hospitalist in a small town. She was told that she would have a guaranteed salary. But she did not read the fine print in her employment contract. The guarantee was actually an advance against future production, or collections. She was required to meet a certain level of collections to support her salary. If she did not meet that level of collections, she had to pay back the deficit. There was a hospitalist outside of and competing with her group. One of the emergency department physicians really liked this hospitalist. If he determined that the patient had good insurance, he called the outside hospitalist to do the admission. If he determined that the patient did not have good insurance, he called my friend’s hospitalist group. They were providing a tremendous amount of care to the patients in the hospital. They were just not getting paid. The longer she worked there, the deeper in debt she was getting. One of her partners did the math and simply left. My friend stayed out of a sense of integrity and fairness to give them time to find her replacement. She was not repaid in kind. And who was going to come and take over for such a terrible deal? She ended up in court and had to pay everything that the hospital was demanding of her. The judge said that it was a terrible contract, but a legally binding one and that she was a big girl and should have read the contract. Her partner who left early made the right decision in that she paid much less to the hospital.

When I was in medical school, we had a medical legal course which consisted of about 10 hours of lectures. One of the things that we were told was to read very carefully anything that we put our signature to. We were particularly cautioned to read employment contracts. I have followed this advice, and it has served me very well. I know of some stories where physicians were badly injured for not having read their employment contracts.

The first question is, “Will I be paid as an employee or as a contractor?” If an employee, then the employer pays half of the Social Security and Medicare taxes. If a contractor, then you pay all of the Social Security and Medicare taxes. If paid a salary, you will get a set amount of money, usually every two weeks or every month. Most people who are paid a salary are expected to work significantly more than 40 hours per week, because there is no additional cost to the employer for extra hours that you work. Many job offers will sound like salaried positions, but close examination of the contract will reveal that all or a significant portion of the payment offered is contingent upon one or more performance metrics. These metrics may include collections, relative value units (RVU’s), quality & efficiency. These may be based on individual performance, group performance or some combination of both. Collections is how much was actually paid for the care you delivered. Usually, a percentage of your collections is paid to the group or hospital for overhead. RVU payment is based not on collections, but on billing. This system is often used by organizations that serve the underserved as it encourages physicians to deliver care regardless of an individual’s ability to pay. Increasingly large portions of physicians’ compensation packages are only paid if the individual and/or group meet certain quality and efficiency metrics. Whether you are actually in control of a metric, the manner in which the metric is tracked & calculated and the thresholds to qualify for the metric all can have significant impact on your actual compensation. Benefit packages can also have significant impact.

In such a short article, I cannot tell you everything to look for. I would advise you to look closely at the exit clauses. When you go to work for a new employer, you have great hopes and even expectations that things are going to go very well. But they may not. I heard of a physician who, within two months of joining a new group, learned that his partners were engaged in and engaging him in activity of questionable legality. The exit clauses in his contract were onerous, and it was very costly for him to leave so early. Issues that may hit you with early separation can include repayment of sign-on bonuses, repayment of moving stipends and noncompete clauses. I was once invited to sign a contract that said I could not work for two years in any hospital anywhere in the United States owned by any company or organization that had a contract with this large physician staffing company (which had hospital contracts in many states).

So how do you go about reading an employment contract? Of course, you are not going to receive a copy of the contract until after you have been given an offer of employment. The contract is usually sent as a PDF. You can either print it out and use a highlighter and an ink pen or, if you can get it into an editable format on your computer, you can go through the document using track changes. You are now going to sit down and read every single word of the document: slowly, carefully and thoughtfully. You will go online and look up the definitions of any legal terms that you do not understand. You can write those definitions in the margins. You can make notes about things that you understand and want addressed and about things that you do not understand. After fully digesting the document, you will either decide to walk away from this job or you will think that this might be doable if the potential employer is agreeable to reasonable changes.

If you wish to go forward, you will now hire an experienced physician employment attorney and will send him or her a copy of your highlighted document with all its notations. You will discuss your concerns. Your attorney will review your document and schedule a follow-up discussion. Your attorney may advise you simply to walk away. Or he may give you a list of items that need clarification or correction. Some issues you identify and some of your attorney’s recommendations will be deal breakers meaning either these changes are made, or you refuse the offer of employment. Others may be that it would be nice if you could get them, but are not that important. With the help of your attorney and your spouse or significant other, if there is one, you will formulate a plan for seeking necessary and desired changes in your employment contract that are reasonable and fair to both parties. Your attorney will help you express your concerns in a language that resonates with the attorney working for your potential employer who will have to give the final approval on any changes to the employment contract.

I will walk you through how I approach these negotiations. I schedule a phone meeting with the individual designated by the potential employer to be their face for the negotiations. My tone is very pleasant and reasonable. I start by saying that my wife and I have carefully read the contract. I have sought the advice of a very competent attorney experienced in physician employment contracts. From these discussions, the following concerns have arisen. If the concern is coming from me, I do not hesitate to say so, but I consider it a good strategy to point out when the concern is coming from my wife or from the advice of my attorney. This is called an appeal to higher authority. It may seem like weakness, but it is a very powerful tool. Used properly, it can tremendously strengthen your position as nothing they say to persuade me will have any impact on how my wife feels about it, especially when it is an issue that is recognized as a reasonable concern for the employee’s wife. When appropriate, I ask for clarification of language in the contract rather than outright changes. Everything that I am asking for needs to be laid out in this first meeting. If you keep coming back with new demands, they may tire very quickly and look for another candidate.

You likely will not get everything you ask for. Just make sure that you get everything you need.

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Early in my career my father shared with me the following advice: “Leave your emotions at home. Do not take your emotions to work.” He was not talking about positive emotions. He was talking about the negative emotions that get so many of us in trouble at work. Chiefly he was talking about anger.

Many people believe that anger is like a boiling, caustic liquid inside of them that can be purged by expressing the anger. They think that they can blow up and “get it out of their system.” But that is not how anger works at all. Anger is like a muscle. The more we express our anger, the stronger it becomes.

Solomon is revered as an extremely wise king. Here is what he had to say about anger. “The discretion of a man defereth his anger; and it is his glory to pass over a transgression.” * “A soft answer turns away wrath: but grievous words stir up anger.” ** “He that is slow to anger is better than the mighty; and he that ruleth his spirit than he that taketh a city.” ***

Ambrose Bierce said, “Speak when you are angry and you will make the best speech you will ever regret.” The regret can be for the harm we have done to others and the harm we have done to ourselves. Anger can do great harm to very important relationships. Sometimes we are able to completely restore the relationship. Sometimes we can only patch it. Sometimes we are left with an irreparable breach. Regardless, our efforts at mitigation may require the expenditure of great effort and political capital.

Our anger can decrease our allies and increase our workplace foes. Whether at work or not, we can never have too many friends and even one enemy is a luxury that we can ill afford. In a large and complex work environment, we may find that we cannot always give everyone everything they want. People may choose to be our enemy in spite of our best efforts. It would be foolish indeed to recruit additional enemies with unbridled, unregulated anger.

On the subject of enemies, I will say that over the years I have had a few people who have chosen to be my enemy. I have never accepted their invitation to join the conflict. When I speak of enemies, I speak of those who bear me ill will, but I am determined to be a friend to all, even those who are my most implacable enemies. I may distance myself from them and take steps to prevent them from injuring me further, but I will not move to injure them out of spite or revenge. It has been said that the best way to destroy an enemy is to turn him into a friend.

Often our anger prompts us to tell people what we think. We would be most foolish to reveal our innermost thoughts to people who are truly our enemies. They have no right to know what we think. Stephen Covey said, “Seek first to understand and then to be understood.” Often our anger is prompted by a distortion in our perception rather than an unacceptable reality. Once we began working off the script of our perception, the victim of our anger will often perceive the barrage as a personal attack, whether it is one or is an attempt to resolve a problem. It is a natural, although often not helpful, response to respond in kind in defense.

Conflict is good. Contention is bad. We do need to resolve conflicts. We do not need to do so in a contentious way that disrupts our organization. I highly recommend the book, Crucial Conversations, for learning how to resolve conflict without contention. This book is so jampacked with valuable knowledge that it should be read, reread and studied to fully master its principles. It has the potential to transform our careers and our personal lives.

Conflict is good. Contention is bad. We do need to resolve conflicts. We do not need to do so in a contentious way that disrupts our organization. I highly recommend the book, Crucial Conversations, for learning how to resolve conflict without contention. This book is so jampacked with valuable knowledge that it should be read, reread and studied to fully master its principles. It has the potential to transform our careers and our personal lives.

* Proverbs 19:11
** Proverbs 15:1
*** Proverbs 16:32

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When I was in college, the church that I attended had a booth every year at the local fair. We made a pastry called an elephant ear. I have seen at fairs funnel cakes which are made by pouring a liquid batter into hot oil and frying it. The elephant ear dough was mixed in a huge mixer. It had eggs in it. The dough was allowed to rise. It was then punched down, weighed out into balls and set on large cookie sheets to rise again. Volunteers sitting at tables would pat the balls into flat disks. These were fried in hot peanut oil and then covered with cinnamon sugar or powdered sugar. In the mid-1980s we sold these for two dollars apiece. They sold like, well, hotcakes. Many people would pay to get in the fair solely to buy elephant ears. There was always a line. If people saw that the line had gotten short, they would run to get in the line. We could sell as many as we could make.

I was in the booth one Saturday morning patting out elephant ears when I noticed Brother “Jones” handling sales. He was a very kind and pleasant man but age was upon him, and he was absolutely overwhelmed with the task. He had before him a line of people who were eager to get elephant ears and behind him stacks of elephant ears growing cold. I spoke to the team leader and asked him if he could arrange for Brother “Jones” and I to exchange positions, of course, handling it in a way that was not hurtful to Brother “Jones’s” feelings. The team leader declined to have us exchange positions but asked me to assist Brother “Jones” with sales.

We began to quickly make sales, and the stacks of unsold elephant ears got much shorter. Soon Brother “Jones” was at one of the tables patting out elephant ears. This was not a terrible place to be. There was always lively and pleasant conversation at the tables, and the task was ideally suited to his capabilities. I now had helping me another brother who was young, like I was, and energetic. We found ourselves waiting for elephant ears to be produced so we could sell them.

A new problem became apparent. The elephant ears were coming out of the vat and were stacking up waiting to have cinnamon sugar or powdered sugar applied. I spoke to the team leader who moved someone to assist with this task. Each time product piled up at a certain point in the process, I would ask the team leader to add or exchange human resources to speed the flow of product through the production chain.

The following day was Sunday. It was announced in church that the elephant ear booth averaged about $11,000 per year in sales, yet the day before we had sold $4000 in elephant ears. The fair would run each year for 11 days. We were not open on Sundays so we would run our booth for nine days each year. This gives us a daily average just over $1200. While Saturdays had more people at the fair than weekdays, demand always exceeded supply even on weekdays. We had tripled our sales that day by simply using our available resources more efficiently.

Several years later while in college, I read The Goal by Eliyahu M. Goldratt and Jeff Cox. This book is a business novel that describes the same process I did in the elephant ear booth but done in an air conditioner manufacturing plant. The protagonist identifies bottlenecks in the production stream by where product in process piles up and then eliminates the bottleneck by moving resources to that step. I highly recommend this book for business leaders.

The ideal value strategy requires no additional investment of resources but uses the current resources more efficiently to deliver quantity and quality, such as: a faster moving line delivering more and hotter elephant ears. We must not be afraid to make small investments when we know that there will be substantial return on investment. Large investments may be necessary and wise, but the larger the investment, the greater we risk, and the higher returns that are necessary to create a value result.

Read previous articles related to this topic:

Article 1: Your business’ future lies in an abundant strategy – not in scarcity

Article 2: Maximum Wow Strategies Lead to Scarcity

Article 3: Fat cutting from an organization can be taken too far – Are you starving your organization?

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A maximum value strategy may involve cutting the fat from an organization, but a maximum economy strategy will cut the meat and bone. A maximum economy strategy has an excessive emphasis on cost-cutting so that it starves the organization of the resources it needs to sustain and thrive.

I will tell you the true story of the only hospital in a town of less than 100,000 people. I will not tell you the name of the hospital or the town to protect the innocent and the guilty. This hospital was sold to a national, for-profit hospital chain. Their emphasis was to pull out as much of the hospital’s gross income for corporate profits as possible. This left very little operating capital to run the hospital. They underpaid their doctors and treated them with contempt. They did not buy necessary equipment and supplies. Deferred maintenance on the building piled up. Many of the doctors moved away including surgeons who were very important to the hospital’s revenue. People in the community began driving to other towns to use the hospitals there. The average number of patients in the hospital each day fell from 75 to less than 10. They wanted it all and slowly they killed the goose that was laying the golden eggs. They wanted everything and ended up with a little bit higher percentage of much, much less.

They saw their market as static and limited. They saw increasing profit opportunities in decreasing their investments in people, operations and infrastructure. They took on a scarcity mindset. They starved the hospital of the resources it needed to thrive or even sustain itself. The hospital wasted away under this neglect and abuse.

Stephen Covey told a similar story in The Seven Habits of Highly Successful People. A restaurant sold a delicious clam chowder that people lined up to buy. The restaurant was sold. The new owners were given all the recipes. They decided that they could make more money if they used cheaper ingredients. Over time people realized that the clam chowder was no longer as good. The lines got shorter and shorter. When the new owners realized their mistake, they tried to go back to the original recipe, but it was too late. The restaurant closed. They bought a maximum value organization and tried to convert it into a maximum economy organization. They shifted from abundance to scarcity and failed.

I am not saying that cost savings and efficiency are bad. If the restaurant owners were paying $3/pound for butter and found the same quality butter for $2/pound from a supplier who was just as reliable, that would be value neutral for the customers and value positive for the owners. But if they instead bought margarine for $1.50/pound, that would be value negative for the customers who are still paying the same price for a bowl of clam chowder. Now the question is, “How would buying cheaper margarine affect the value equation for the owners?” The new owners thought it would be value positive. They figured that they would pay less for margarine and get the same price for a bowl of clam chowder. But the customers stopped buying the clam chowder. The little bit extra profit they made buying cheaper ingredients was small compared to the income they lost from reduced sales. It was also value negative from the owners.

Here is an important take away. Be very careful about changes that you suppose will increase your value results while reducing the value results for your customers and other stakeholders. That is seeing your customers and important stakeholders as members of the opposing team instead of being on your team. And when they realize that you are not on their team, they will abandon you as soon as a viable alternative presents itself. Where the value equation really counts is in what you deliver to your customers and other important stakeholders.

A maximum economy strategy is a scarcity strategy. It is driven by pessimism and lacks vision. It is excessively focused on cost reduction without weighing the impact on quality. It will fail to deliver value (quality divided by cost) and will likely lead to weakness and failure.

Read previous articles related to this topic:

Article #1: Maximum Wow Strategies Lead to Scarcity

Article #2: Your business’ future lies in an abundant strategy – not in scarcity

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See Previous post.

A maximum wow strategy is when a lot of money is spent on something grand, splashy and showy that delivers little or no value to the company or its customers.

A prime example of this is when a company builds an expensive and extravagant off-site corporate headquarters. When I was a young man, my father told me, “Son, beware of your ego. A man’s ego can get him into a lot of trouble and cost him a lot of money. Ego trips are very costly.” Many a company has been severely weakened by a CEOs ego trip of building a lavish corporate headquarters that often was not even needed. The offices they already had were serving the company just fine.

For a counter example I would offer Walmart. Walmart is the largest brick-and-mortar retail establishment in the world by a very large margin. Its corporate offices have for many years been in the top of its warehouses in Bentonville, Arkansas. Top corporate officers are in plain offices with cheap wood paneling and utilitarian steel desks. This proximity to its distribution centers gave corporate officers a profound and intimate understanding of the needs of its supply chain. Walmart developed the most sophisticated automated distribution centers of any brick-and-mortar retailer. These sophisticated automated distribution centers are credited with a large part of Walmart’s competitive advantage over other brick-and-mortar retailers. This is Sam Walton’s legacy. As wealthy as he was, he was a man without an ego. He was a form follows function kind of man. Good enough was good enough. We will save excellence for our customers.

If a competitor had wanted to destroy Walmart, instead of building a gleaming corporate headquarters in the downtown of a major American city for themselves, they would have built and paid for one for Walmart on the condition that they must house their corporate officers there. This would have isolated Walmart’s leadership from the needs of its supply chain and decreased the likelihood that they would have ever built their automated distribution centers costing them their current competitive advantage.

Value is defined as quality divided by cost. So how do we define quality? Is it a large towering building built of the finest materials and sitting on a piece of prime real estate? Or is it proximity, awareness, humility and engagement? I would argue that Walmart’s choice of its corporate offices was the value decision not just because it delivered at a lower cost but also because it delivered a higher-quality leadership engagement for the company.

A maximum wow strategy is company leadership writing big checks and taking on heavy debt to be paid for by the company for ego-driven projects that deliver low value to the organization.

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In Abundance: The Future is Better Than You Think by Peter H. Diamandis and Steven Kotler, the authors make the point that technological developments and continuing innovation will bring to the world a future of abundance rather than scarcity, of increasing prosperity rather than increasing poverty. I believe that they are right so long as we can maintain freedom in general, free markets in particular, reasonable levels of taxation and relative peace throughout the world. As I pondered on the ideas they presented, it occurred to me that a business leader needs to have an abundance mindset in strategic development. An overall scarcity strategy cannot bring a strong and bright future to an organization. We cannot simply cut and slash our way into growth and prosperity. Nor can we simply spend our way into growth and prosperity. An abundance strategy is one of tremendous value generation.

My wife and I built a home using a general contractor who builds custom, luxury homes. I commented to him one day that it had occurred to me that there are three types of people who buy a custom home:

1. Maximum WOW! These buyers do not care how much it cost. They want to upstage everyone else at any cost.
2. Maximum value. Value is defined as quality divided by cost. These buyers are willing to spend more money if they get a good return on their investment relative to their experience living in the home and to their resale value.
3. Maximum value. Value is defined as quality divided by cost. These buyers are willing to spend more money if they get a good return on their investment relative to their experience living in the home and to their resale value.

I told him that I thought that he could build homes for wow buyers and value buyers, but he could not build a home for an economy buyer to which he agreed.

At first glance we may be tempted to see a maximum wow strategy as an abundance strategy, but maximum wow and maximum economy are both scarcity strategies. Both strategies are low value generation strategies, and low value generation will sooner or later lead to scarcity. In maximum wow the cost is too high relative to the quality generated. In maximum economy the cost is low, but the quality generated is too low relative to that cost. The abundance future is in high value generation that comes in a maximum value strategy.

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