Over the last four weeks or so I have touched and been touched by the ‘medical system’ in the UK – in particular my doctor’s medical practice and the NHS (national health service). I want to share with you the key insights that opened up for me on people and organisations.
Women show up as being more caring than men
Women as a whole whether in the role of receptionist, ‘blood taker’, nurse, trainee nurse or doctor simply show up as being more caring. In their being and in their doing they transcend the merely functional – the task. They put their humanity into the encounter – they smile, they strike up a conversation beyond the merely functional, they reassure, they do more than is necessary. The men, as a whole, focussed on their area of expertise and the task at hand. They are distant. They stand farther away (afraid to get close), they don’t smile, they are matter of fact, they focus on the task, time is clearly of the essence as they are keen to move on to the next person, the next job. There are exceptions. One female receptionist was particularly cold, clinical and showed up as being disconnected from even a thread of humanity. On the other hand Dr Jeremy Platt is almost always smiles and greets me warmly and takes the time that is necessary.
Insight. If we genuinely want our organisations to ‘touch’ our customers so that we show up as caring and thus create a space for emotional bonds to show up and form then this challenge has to be addressed. Men, as a whole, are one dimensional – functional. Either they are emotionally illiterate – that is to say that they are not in touch with their caring emotions or the cultures/communities they are embedded in do not give them permission to express their caring emotions. I suspect it is combination of these two factor – their is a lack of permission to show caring as this shows up as ‘soft’ and over time men lose touch with these soft emotions.
Question/Challenge. If the Tops got to the top by being ‘macho’ and ‘functional’ then how likely is it that these people will undergo a transformation and embody the softer emotions, values and associated practices which are the key to showing up as caring? Perhaps they will take the Steve Jobs approach – build that caring into the product. Or they will take the Amazon approach: build that ‘caring’ tone into the design of the operations. Yet, these approaches are not enough in services heavy industries where people (the employees) are the product, the experience and there is intimate contact between the customer and the employees.
The people on the front line can show up as ‘robotic’ and ‘inhuman’ because they perceive themselves to be powerless
I turn up at the scheduled 8am appointment for the endoscopy. Pain is present – that is the reason that I am there, to figure out what is the cause of the pain. The nurse ‘sells’ me on taking the right course of action – taking the sedative as it will relax me. I agree, I tell her I am in pain and so the sedative is the right way to go. Then she asks me who will be coming to pick me up and take me home. I tell her that my wife cannot pick me up until 3pm and that if I am well enough to go home earlier then I plan to use my favourite taxi firm to get me home. She responds by saying that she cannot offer me a sedative unless I have a family member to take me home and look after me for the next 24 hours – that is the hospital policy. I say “If you are not going to give me a sedative then you are not going to give me sedative. I am ok with that.” Except that I am not really OK with that.
Later the Consultant- the specialist who is going to do the endoscopy – comes to see me with the nurse trailing behind. He asks me some questions, I answer. Then he asks me why I have chosen not to have the sedative. I tell him that I want the sedative and I have been told that I cannot have it. And I tell him the reasoning. He tells the nurse that he will be giving me the sedative as that is the right course of action given the pain I am in and the procedure involved. He tells her to find me a bed.
Instantly the whole being of the nurse changes. It is clear that ‘God’ has spoken and his command must be obeyed without question, no excuse will suffice. She tells the doctor that she will ring around several wards and that she is confident that she can find me a bed in a specific ward. There is no doubt in her voice, absolute confidence. She leaves and several minutes later she comes back and tells me that she has found a bed for me. I am amazed at the instant/profound change in this nurse. It occurs to me that she is happy/proud at what she has accomplished; she has a big smile on her face and her tone of voice is different.
What is going on here? For the better part of 20 minutes or so this nurse showed up as robotic – going through the motions, following the script and preaching policy, ignoring my needs and the right thing to do, even changing her advice 180 degrees. Then the Consultant shows up, tells her what she needs to do and instantly there is a new human being in front of me: confident-resourceful-helpful as opposed to helpless and robotic.
What made the difference? I say she was given permission from THE authority figure to bypass policy and put her knowledge, her resourcefulness, her caring into action. I say that the Consultant showed up and instantly changed the context from which the nurse was operating from: from be a good robot/ follow the script/procedure to here is challenge/make it happen. Furthermore, the nurse was absolved from responsibility and blame – she was simply following orders. Which reminds of the Miligram experiments in obedience to authority.
Insight. When we look at poorly performing front line employees the tendency of managers, management consultants and the training industry is to assume that the fault, the deficiency, lies in the front line employees. In short we have an automatic bias. This reminds me of the story of the drunk looking for his lost car keys under the street lamp when he had lost them somewhere else. The smarter place to start looking for performance issues is in the context/the environment/the ‘system’ in which the front line employees are embedded and operating from. That means facing the reality: in about 95% of cases ‘poor employee performance’ shows up because it is the natural, inevitable, result of the assumptions/prejudices of the Tops and the ‘system’ that they have designed, actively or passively, to cater for those assumptions/prejudices. Let me put it bluntly, if you want to drive up performance and the customer experience then focus on the managers, the management style, the organisation design. That is where the real leverage is for step changes in organisational performance, customer experience and customer loyalty.
I will continue to share my insight with you in the follow up post – part II will be coming soon. If you are up for it then I’d love to hear your thoughts.
Some of you have been kind enough to enter into a conversation with me by commenting. You will have found me wanting – I have been lax in responding to your comments. I ask for your forgiveness, my excuse if there is one is simply that the last four weeks or so have been a struggle: the body, my health is not showed up as being my own.