Aligning Incentives is a Big Challenge for the 21st Century Leader

Do you known why you don’t see elephants hiding in trees?
Because they are really good at it.

My daughter, Charlsea, hit me with this joke this week. It struck me as being really funny. Later, I was thinking about it. It was funny to me because when I heard it I found myself “seeing” – in my imagination – elephants hiding in trees for the first time ever and they were doing it better than I thought possible. It occurred to me, “Because I haven’t seen something doesn’t mean it doesn’t exist or can’t happen.” It may simply mean that I haven’t experienced it yet. This realization brought a couple of things home to me. One, we are exposed to new and different things every day. Two, sometimes we don’t catch on until there is something in it for us. 

Fifteen years ago, I was exposed to the rudiments of Population Health Management. I have played in and around them ever since; to the extent I paid any attention to them, it was incidental to other work I was doing and I never gave the concepts’ intrinsic value due consideration. Only when friends and business partners brought them into focus for me and put them in perspective as a new imperative did I appreciate their importance to what I have been doing in the past and wanted to do in the future. I saw an elephant in a tree for the first time.

Seeing the Forest for the Trees

Seeing the Forest for the Trees

Sometimes, we just don’t see the forest for the trees. About two weeks ago, I started thinking seriously about Population Health Management and how learning more about it could help me personally. Why? Because people who I respect told me it matters and that speaking intelligently to it and the principles underpinning it will help me in the organizational development of healthcare organizations. They incentivized me. They did not do so consciously, they simply told me what they were seeing from their personal perspective. As I envisioned what they shared, I saw what I had missed and the cost I had paid to date in doing so. I did not want to continue incurring that opportunity cost going forward. Ignorance is bliss, finding out what you weren’t doing that you might have been doing (to your personal and professional advantage) is not. 

What’s In It for Me?

What’s In It for Me?

Since my last blog, I’ve participated in no less than four meaningful conversations about the evolution of PHM over the last twenty years. At some point in each of those conversations I realized that despite my early entry into the arena while in Alaska, I let my orientation slip; now I am playing “catch-up”. I began mentally kicking myself as I realized I missed “what was in it for me” back then. I caught myself in the “If only … What might have been?” game. It works like this, “Man, I was really into this health care information data collection, analysis, application and management stuff back then. What if I had made it my focus then and had become a real expert even up to its current applications in Population Health Management?”  Woe is me. 

My issue isn’t that I asked, “What’s in it for me?” My issue has only to do with when I asked the question. When we ask “What’s in it for me?” after the fact, any fact, it comes out, “If only I had… I would have…” It becomes a complaint for what we don’t have or for what’s missing. Usually, it stems from jealousy. We see someone who has something we don’t; they have something we might have if only we had realized what could have been in it for us, the action we didn’t take.

When we ask “What’s in it for me?” prospectively, the question and the answers to it become very powerful motivators for action and persistence. “What’s in it for me?” becomes our “Why”. Our “Why” is what keeps us going when the going gets tough. If our “Why” is authentic and big enough, it can carry us over any hurdle in our path. Asking yourself “What’s In It for me?” prospectively is selfish. There is nothing wrong with being selfish; it is basic human nature. Only being selfish at the expense of others is negative. When we know what is in it for us (whatever “it” might be), we are in a better position to give others whatever they may want or need. 

About the author

Dr. Ed L. Hansen

This blog is written by our guest author – Dr. Ed L. Hansen. He has C-Level leadership experience and expertise (as CEO, COO and CFO) in government hospitals and health systems; not-for-profit community hospitals; and corporate, for-profit hospitals. He has been the CEO of an international multi-facility hospital group.

As an employed hospital executive and as a consultant, Ed has led major construction activities, hospital and clinic service development activities and new healthcare business start-ups, including an award-winning international air ambulance company. He is particularly strong in the areas of operating systems design, implementation, maintenance, re-engineering and evaluation. He has addressed the Bond Covenant violations of several struggling hospitals. In these cases, he and his teams effectively turned-around their operational and financial performance.

Read more at Part 2

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