Physician’s Dilemma

Welcome back, Coach Alan!  It has been a while since I last blogged about coaching.  I took a summer break to focus on a book I am writing about General Motors (GM).  I am writing this book with a remarkable top GM executive (now retired) who was personally responsible for not only saving a large GM plant from closure but also for changing the plant’s culture to allow it to flourish.  He was a masterful coach, long before coaching was popular.

Physician’s Dilemma

My blog today was presented by a physician coachee who was faced with a dilemma.  He is a member of a university-based surgical practice.  As part of this practice, he has developed a pre-operative weight-loss program to help patients become better surgical candidates.  He would like to train one of his office medical assistants to coach patients through this weight-loss program.  The medical assistant, a woman, would go through the program, allowing her a firsthand understanding of what the patients will experience.  Like many of the patients, she is overweight. The dilemma is that she wants the new opportunity but is not willing to go through the nutritional program.

What is the physician to do?

First, it is not clear whether the medical assistant is coachable on this matter. Although she has expressed a strong interest in this new role, it is unclear as to why she will not go through the program.  From a rational sense, it seems like an easy decision.  By accepting the physician’s request to go through the program, she demonstrates initiative in expanding her professional career, gets to go through the weight-loss program as a benefit of employment, loses weight, establishes credibility with patients, and becomes a healthier person.

Easy decision, right?

Let’s take a look at other possible explanations for her decision not to participate. She may have a fear she will not be able to complete the program, letting the physician down.  She may also be comfortable with her current weight and see no reason (tension) to lose weight.  Or she may be thinking of the cost of new or refitted clothing.  In short, she may have her own valid reasons for not participating

Coaching the physician on how to resolve this dilemma may not lead to the outcome he prefers. What he needs to do from a coaching perspective is to create tension between the medical assistant’s job requirements and her willingness to meet them.  She must decide on which course of action to take.  If she really wants this role and her motivation is strong enough to overcome her reluctance to take on the program, she will be on her way to closing the gap and reducing tension.  If this gap is not strong enough to overcome her reluctance, she will likely pass on the new role.  It is possible that she will reframe the situation and accuse the physician of demanding a condition that is unrelated to the success of a weight-loss coach.  Here, the physician needs to justify the job requirement as reasonable and necessary for a successful patient coach.

This raises an ethical question.  If the assistant in question were not overweight, would the weight loss program still be required?  If the answer is yes, there is no ethical issue; in this case, the program would need to be modified to maintain the assistant’s health.

In sum, we can’t always have what we want.  In the case described above, the physician must create tension, but he does not control how this tension will be perceived by the medical assistant in question.  We can predict, however, that the assistant will either go through the program, or our physician will be hiring another person to coach his patients. In either case, creating tension will bring about a timely resolution to our physician’s dilemma

Physical Tension as a Metaphor for Behavioral Change

I believe one of my assets is to think metaphorically.  As a teacher, I was able to utilize this asset to explain complicated concepts to students.  Sometimes, I used a case or an illustration to amplify a concept. For example, when I was explaining balance theory as a psychological concept, I would tap into student knowledge about supply and demand from economics or homeostasis from biology.  So, when one of my coaching clients analyzed my approach to coaching from an engineering perspective, my ears perked up, and I asked him to write this blog post with me.  Our goal is to explain how to create change. Our hope is that by relating engineering principles to behavioral change, we will add some clarity and understanding of how coaching works.

Ray Mercer, president of Aurubis Buffalo, a copper and brass manufacturing company in Buffalo, New York, summarized my coaching as a process.  He characterized my coaching as the creation of clarity about a situation, developing the case of what needed to change, followed by creation of tension for change, and further followed by energy dedicated to making the change. He pointed out to me that nothing works in our physical reality without tension.  I had never thought about this, so I asked him to elaborate.  Here is what he wrote.

As an electrical engineer, I know that to get current to overcome resistance and flow, I need a “potential difference,” called voltage.  In layman’s terms, this is literally electric tension.  My mechanical engineering friends would offer more examples.  In hydraulics, we need a pressure difference for fluid to flow.  In heat transfer, we need to create a temperature difference for heat energy to flow.  And the simplest of all, when we compress a spring, we create tension, and we get an opposite reaction.  We use this tension to close a door or get a pen to retract.  The list goes on and on. Engineers implicitly understand that in order to get a desired action, you first need to create a form of tension.  It is the basis of how nature works and a fundamental element in almost every mathematical equation that describes this natural behavior.

Ray further commented on the quality of tension.

In our industry, we have pressure-pour molten copper casting furnaces.  The technician needs to supply exactly the right amount of pressure (tension).  Too little, and the molten metal freezes in the spout, and the operation fails, leaving a mess to deal with.  Too much pressure, and the casting mold can overflow and potentially cause an explosion in the worst case and a mess in the best case.  Good pressure or tension control is essential to get the desired result.

The above example provides an excellent metaphor for behavioral change. In coaching, constructive tension is created with the intention of reaching a positive outcome.  Too little tension will lessen the motivation to change.  Too much tension can be debilitating and lead to behaviors that will potentially sabotage desired change.   Negative tension in coaching can also create problems.  Such is the case when a person in authority is forceful in demanding change.  This not only creates negative tension but displaces tension toward the wrong objective, the person creating the tension.

I will use Ray’s examples to help people understand my coaching process.  And I will continue to identify the tension between what coachees aspire to and their current state in order to move them closer to their goal.  It helps to have examples from other fields that amplify and explain how coaching works to create change.

Navigating Change in a Family Business

Dear Coach Alan,

I am the president of a manufacturing company. Recently, the CEO, who is the sole owner of the company, and I recommended an organizational change that would integrate a satellite division that supplied the main operation with product into the main manufacturing operation. The satellite division VP who had up to now reported to me would report directly to the VP of operations.  The satellite division supplied the main plant with parts used in its manufacturing process. Due to our growth, the satellite operation needed to have closer ties to the main manufacturing.  This would bring the satellite division into closer conformity with human resource policies.  It would also help to coordinate state-of-the-art processes such as Six Sigma and lean manufacturing.  The only problem was the VP of the satellite company reacted negatively to the organizational change.  He felt this was a demotion and that the VP of operations would be micromanaging him.  His reaction was so strong that the CEO, who is also a relative, decided to put the organizational change on hold.  This makes me and my VP of operations look bad, and it stalls our efforts to improve organizational effectiveness.  What can I do to move this change forward?

George P.

George, you have recognized organizational gaps and have recommended change to eliminate them.  Congratulations.  Changing the organization to better meet the demands of the company is a role that you obviously take seriously.  I see two issues that you need to sort out before you implement the change you have proposed.  The first is the support of the CEO for this change.  The second is the reaction of the VP of the satellite division.

This is obviously a family business.  As such, the CEO must decide if the company will be run as a business-first or a family-first organization.  In other words, is he willing to make decisions based on the needs of the business or the needs of family member?  From a coaching perspective, you may need to confront the CEO with the dilemma you face in improving organizational effectiveness while dealing with a family member who resists this change.  Do you have the full support of the CEO to implement the change?  If so, what does the CEO need to do to back up this change?

Assuming you have the support of the CEO, you then need to gain the support of the VP of the satellite division.  By now, he has had a chance to process the change.  His initial reaction should not be surprising.  He very likely interpreted the change as a personal failure.  Your job will be to reframe the change as one that the organization needs to improve its effectiveness.  You may want to acknowledge the feelings this VP is experiencing.  This recognition will demonstrate empathy.  You may even want to encourage some venting of the feelings this executive is experiencing as a way of releasing pent-up emotions.  Rational dialogue is much more likely after the emotion is released.

As a coach, you might consider sharing your views of the ideal organizational design, including the integration of the satellite division with the main operations.  What are the gains that will take place once the reorganization is implemented?   If the change were not to take place, what are the losses that the company would incur? Do you have the support of this executive to help the organization realize these gains while avoiding the losses?  By reframing the change from a company perspective, you take the emotion out of the decision.  You will soon find out whether this VP really is able to shift his focus from a personal to a company perspective.

The final piece needed to implement this change is to have both VPs review the new reporting relationship.  What will this relationship be?  Your VP of operations will need to be sensitive in moving this relationship from that of a peer to a role of manager.  And, of course, managing a family member will have its challenges if the family member is allowed to triangulate relationships with the owner/CEO or other family members. As the coach of the VP of operations, you should consider goals for this relationship with frequent updates on how it is proceeding.  Be sure to keep the CEO informed about your progress and gains in implementing the change, as well as the relationship between the two VPs.

Family businesses have challenges that can complicate leadership.  Open dialogue and sensitivity to the family relationships will help you navigate through these challenges.

Using a balance sheet to change behavior

Dear Coach Alan:

I have an executive, Charlie, who is up for promotion.  While he is talented and productive, he is also polarizing and is perceived by his peers as highly emotional and full of bravado.  He can be irritating and, at times, self-destructive.  This executive has an important role to play in our organization. I would like to keep him. What can I do to “save” him?

Jack P.

Using a balance sheet to change behavior

Dear Jack,

In describing Charlie, you have described some of the attributes of what I would call a “personal balance sheet.”  This is a good beginning to create a strategy for “saving” Charlie.  We all have a balance sheet of assets and liabilities.  Our goal should be to leverage our assets to get the most out of them and to manage our liabilities to minimize their negative effects. In your Charlie’s case, his personal style seems to be the problem.  While he appears to be an achiever, he also demonstrates negative behavioral tendencies.

The first thing I would do is to describe the behavioral expectations for Charlie.  How would you like him to behave?  Ideally, what should his peer relationships look like?  His role should be described clearly and communicated to him so he is aware of your organization’s expectations of him.  To provide him with a contrast, I would recommend that you offer him examples of the behaviors that you describe as irritating and self-destructive. Once this gap has been established, Charlie needs to know that it is up to him to close it gap if he expects to be successful in your company.

At this point, you need to decide whether you will assign an internal or external coach to facilitate Charlie’s change in behavior.  In my experience, you are more likely to achieve success by bringing in a coach with experience in behavioral change.  If Charlie truly wants to change his behavior, he will appreciate your investing in a coach to help him to achieve this change.

There are several approaches that may help Charlie to change.  One I will offer here is to recreate experiences where he demonstrated the negative behaviors you described.  By reflecting on this behavior, Charlie should become aware of the negative consequences that resulted from his behavior.  Then, Charlie can reach into his assets to identify how he could have acted differently by using his assets (e.g., achievement).  If Charlie can “reframe” his interactions using his assets to guide him, he will identify alternative behaviors that have a greater likelihood of not only managing his liabilities but moving him closer to his goal of adopting more constructive relationships.

I call this approach “reflective learning.” Essentially, it encourages Charlie to re-analyze his behavior through a different lens, using an asset to guide him. The success of this approach is predicated on the ease with which Charlie can reframe similar situations using his assets rather than directly trying to alter his negative behavior. By substituting an asset for a liability, the chances of success go up.

In sum, Charlie needs to save himself. Your role is simply to provide him some coaching support that will facilitate this change.

The Perils of Rewarding the Wrong Behavior

Dear Coach Alan,

I am the owner of a small but profitable professional services company.  My top performer, Joe, keeps asking me for more money.  Several years ago, I put Joe on a profit-sharing program.  His annual bonus is a percentage of the profit earned for the year. Now he keeps questioning expenses and other deductions from revenue, including his own bonus. It has gotten to the point that profit-sharing has turned into a nightmare.  How do I get Joe to stop challenging me and the company income statement?

 Steve P.

Steve, you may have created this dilemma by basing Joe’s bonus on profits.  Because money is so important to him, he is questioning anything that reduces profits that, in his mind, is not a legitimate expense. I agree with you that this needs to stop.

You might begin by asking what your goal is in compensating Joe. Is your purpose to make him feel like an owner?  This is the usual reason why profit-sharing is presented to employees:  they then share in the success of the company. They also share less in down years.  Not all employees trust the honesty of profit reporting. Small businesses often write off marketing costs, entertainment expenses, and membership fees that are used to generate business.  Expenses also include overhead that might be challenged by less-trusting employees.  For example, an employee may question why the boss plays golf with customers when he or she should be adding to revenue. Also, most employees are risk averse. They prefer to have certainty to their compensation. As one my colleague states, “Profits are about risk, and pay is about work: don’t confuse them.”

If the purpose of compensation is to reward Joe for his productivity or billable time, then profit-sharing may not be the preferred method of compensation.  You may want to consider a bonus program based on the revenues Joe produces. This is easy to track for you and Joe.  Because Joe has more control over his productivity, he will have fewer challenges over the method of determining his bonus, whether it is billable time or margin.

Summarizing your dilemma, you need to decide on how to compensate Joe.  From what I can determine, he seems to want more income and control, not ownership.  Therein lies the clue on how to choose the best compensation program for Joe.

If you accept the assumption that Joe wants to maximize his income, you should consider having a candid conversation with him about his compensation plan.  You may want to point out how the goals of an owner are different from those of an employee. Unless he is willing to risk part of his compensation, the two of you need to agree that a change is in order.  The tension you create by contrasting a compensation plan based on profits with one based on Joe’s productivity should be sufficient to demonstrate the need for change.

Your next challenge is to design a mutually beneficial compensation plan.  You may decide to hire a compensation consultant to help design this plan, or you may do it yourself, taking into account Joe’s needs and your desire to motivate him.  By bringing Joe into the plan’s creation, you will likely get less hassle from him about fairness and how you choose to spend company money.  Anything you can do to reduce the tension between you and Joe and raise the tension between Joe’s desire to make more money and his generating more revenue for the company will yield positive results.  You can even include customer satisfaction in the plan.

I have always viewed compensation as a reward for performance.  It is important that the reward be related to the goals of the company and the behaviors that are consistent with its values.  In Joe’s case, the misalignment of rewards and behavior is creating tension that needs to be eliminated.  As Joe’s coach, your job is to make him aware of this and create a compensation plan that is relevant and within his control.

Turning an Asset into a Liability

Dear Coach Alan,

I have an executive whom I would rate as an A player.  He may even be my successor.  His name is Tom. Tom has many assets, but there is one area of leadership that concerns me.  He is so good at reasoning through problems that he seems invulnerable to several of his associates.  These associates are reluctant to approach him with concerns because they feel he will turn the approach into a debate, which he will ultimately win. Don’t get me wrong; his associates love and respect him. My concern is that he may be undermining his leadership by sending an unintended message that stifles two-way communication and openness.  How can I help Tom to become aware of this liability and encourage the actions he needs to take that would allow his associates to be more open with him?

Sandra M.

Well Sandra, this is a challenge.  It seems to be a case where an apparent asset may have turned into a liability.  It is likely that Tom has learned that his ability to perceive a problem and solve it has been a positive asset in his success and promotion to a leadership position. Now that he is in a leadership position, his role has changed.  He is no longer the “expert” who is rewarded for solving problems. He is now responsible for developing his associates and listening to their views and challenges and encouraging them to solve problems on their own.  His role has changed into one of a coach and not the expert.

This may seem like an obvious shift, but it is sometimes a difficult one to make. Our behaviors often become habits, and “unlearning” habits that have worked for us in the past requires both insight and the learning and practicing of new behaviors. Developing a clear understanding of his leadership role is the first step in helping your Tom.  What he does not want to do is create a culture that makes people feel vulnerable and incompetent. By adopting behaviors that encourage two-way communication and encouraging associates to do the “heavy lifting” and problem solving, Tom will build their confidence and competence.

One way for Tom to encourage his associates to be more engaged is for him to ask probing questions that lead to deeper thinking.  Good coaches are masters at asking questions that require reflection and consideration of the many factors that go into problem solving and decision making.  As his coach, you may want to have Tom reflect on a specific experience in which he behaved in a way that shut off communication and limited involvement by his associates in resolving a problem.  You should encourage him to analyze this experience by exploring the consequences of his behavior from a leadership/culture perspective.  Once he “gets it,” encourage him to practice asking the kind of questions that will encourage his associates to become more engaged in problem solving.  You may even try to role play with Tom.  You could play the role of one of his associates, and Tom, being the coach, could ask you questions that help to get you more engaged in problem solving.

I would like to make one last point. Very bright people who are looking for short cuts and efficiency often justify their behavior as an effective use of their time and energy. They fail to understand the negative consequences of always being in control and demonstrating their ability to resolve problems quickly.  As his coach, your role is to help him to understand that his need for efficiency can undermine his leadership effectiveness.  To grow as a leader, he needs to stop doing the “heavy lifting” and delegate this skill to his associates.

Dear Coach Alan,

I am the president of a small manufacturing company. How do I keep my executive team from letting day-to-day firefighting interfere with their strategic goals?  Is my company too lean? Do I need to hire more people? Does my team need more training?

Ken B.

Ken, this is a great question.  My first response is that you have a head start in finding the answer to your question just by recognizing the problem. I hear this complaint all the time. I am reminded of Steven Covey’s discussion about how urgent demands often get more attention than important ones.  The urgent tends to demand our immediate attention—even if it shouldn’t.  And, there will be no shortage of these kinds of demands that challenge us throughout a normal business day.  I have often heard executives comment that they had a busy day but accomplished little.

You have several options to consider.  But first, it is important to define a strategic goal for your company.  Most companies use this term to identify a major initiative that will differentiate them from their competitors and give them a competitive advantage. Typically, there are also actions that need to be taken in order to accomplish a strategic goal.  This is not what you are concerned about.  Your concern is how to get your executives to stay focused on strategic initiatives and not be derailed by distractions that may seem urgent but are actually less important.

Before you go out and hire people or second-guess your staffing needs, you may want to get a better understanding of why your executive team members are not staying focused on strategic initiatives. Do strategic goals exist for your company? Did your executives participate in the creation of them? Were the strategic goals well understood?  Is your team aligned with you in pursuit of these goals? Are they aware of how important it is for them to accomplish these goals? Have they shared with you their frustrations and distractions as obstacles in maintaining focus on strategic goals? How committed are they to the company strategy and initiatives?

As their coach, it is important that you create tension between the strategic goal and the current status of where your executives are in reaching this goal.  The difference between the two is the gap that needs to be closed.  If an executive is committed to the strategic goal, the tension will be strong to close the gap.  Through carefully crafted questions, you will need to facilitate a dialogue that will focus your executives on understanding their challenge and creating the action steps needed to accomplish the goal.

If your team is cohesive and buys into the company strategy, one option you might consider is group coaching. In group coaching, each team member can be encouraged to offer examples (reflections) of how he or she gets diverted from working toward a strategic goal.  The group can ask clarifying questions to be sure they understand the situation of the presenting team member.  Then, the group can offer suggestions on how the team member can manage the urgent demands while staying focused on the strategic goal.  Each team member should offer an example of the same dilemma; the group will go through the same process of questioning and offering ideas to help the coachee. This process, which is sometimes referred to as “guided discussion,” is a great opportunity for executives to share their challenges while engaging in problem-solving behavior.  The challenges presented are real, and the support given to each member by the team will be felt and appreciated.

I highly recommend you follow this team learning with individual coaching sessions.  These sessions will reinforce the team learning.  They will also give you the opportunity to reinforce the executive’s commitment to the strategic goal.

If your team members vary in their commitment to a strategic goal, or if there is little alignment of team members, individual coaching is your best option. You can use the same process of inquiry as described in group coaching but without the additional breadth of group feedback and shared learning.

There are many advantages of individual coaching sessions. Some individuals are more comfortable in a one-on-one meeting than in a group meeting.  Individual coaching sessions will also give you and the executive the opportunity to explore challenges that were not part of the group coaching session.  Another important reason for individual coaching sessions is to communicate how important the coachee’s achievements are to the company’s mission and goals.  Giving your executive team members personal time is a way of showing your support for them as individual contributors.

Ken, I hope this answers your question. As a coach, your role is to bring out the best in your team members and provide the resources they need to accomplish strategic goals. This requires full engagement, communication, and commitment. Coaching plays an important role in accomplishing your objective of keeping your executives focused on what is important to their success and the success of your company.