Adaptive Strategies Blog

ATTENTION! ATTENTION PLEASE!

Please excuse me while I get up on my metaphorical soapbox and have a short rant.

We are becoming intellectually lazy and losing our ability to reason!! 50% of American households buy a newspaper today while over 100% bought a newspaper in 1950! (Over 100% because we had morning and evening editions then.)

OK, I’m down from the soapbox and I have a question for you. Is the above conclusion a good conclusion? Or am I simply A CRABBY OLD MAN ranting about the “younger generation?”

Not sure? Here, try this one instead. “People who drink green tea show a lower incidence of heart disease. Therefore, drinking green tea reduces the risk of heart disease.”

OK, maybe I am a crabby old man, but both examples show bad reasoning.

In the first instance I used emotion (bold type and double exclamation points) and then gave you an unrelated fact to “back up” my statement. Hmmm, do you ever see that kind of “reasoning” coming from our politicians, or talk-show hosts? Maybe in the current healthcare “debate?” In the second example I gave you a conclusion based on a related fact – but a fact that only showed correlation, not a cause.

If you want to be prepared for the future you have to reason well and good reasoning requires that we challenge the “facts” and assumptions that underlie our thinking. Good reasoning is informed through ongoing learning; and new data comes through the skill of observing. Finally, we test our reasoning and the results of our decisions when we reflect.

But let’s get back to the rant of intellectual laziness. (I like ranting, it comes with age.) Good thinking requires that we use evidence to support our conclusions. So here is my Prepared Mind question of the day: Where do you get your evidence for the decisions and actions that guide you and your daily life? Do you take the time to educate your thinking process? Are you willing to plow though a fifteen page article in Atlantic Monthly magazine or do you pick-up your “factoids” from USA Today? By the way, newspaper readership is down significantly, so where are we getting “the news.” And, for that matter, how much of the news on TV or the web or radio is really important news?

Reasoning is hard work and it takes time; so, sometimes, we get a bit lazy and let others do our reasoning for us. Or, we let opinions substitute for reasoning. And, more often than not, we form our opinions based on “received knowledge.” That is, we let others tell us what to think. We see this all the time in people who are devoted to a political or religious ideology. (Does Rush Limbaugh or (now Senator) Al Franken do your thinking for you?) When this happens we fall into the traps of never looking for disconfirming information or not considering other points of view.

Going back to my opening rant, I really do believe that we are becoming intellectually lazy. And I mean ALL of us, not just the younger generation. That’s my opinion and I’m sticking to it. Now it’s your job to prove me wrong. You can give me your opinion (which I’ll ignore because it does not support my opinion.) Or you can reason with me. It’s your choice.

Come on – REASON with me!!!!!

More about the eight skills of the Prepared Mind.

In the past two weeks I’ve touched on the skills of Challenging and Observing. Here’s another skill you need to consider – the skill of deciding

Why do you get paid? Let me be blunt – if it’s not because you have responsibility for making or influencing decisions at your organization, then your job is in big trouble.

It’s easy to outsource “transaction stuff” (“Why yes, I’ll be happy to take your order for …”) and it’s even easy to outsource important “knowledge stuff” (Was your recent x-ray read by a radiologist in your hospital or in another country?) However, decisions and decision making stays close to home – this act of management is too important to outsource (that said, has your organization outsourced key decisions to your local band of consultants? But that’s another story.).

Get it? You want to be in a position that accepts the risk (and rewards) of decision making.

So where does the concept of having a Prepared Mind come into play? Well, there are plenty of books that delve into the mechanics and processes of good decision making. They are important, but not enough. If you are going to be prepared for your future, and make good decisions that will bring your organization into the future, you need to consider (as Peter Drucker put it many years ago) the “futurity of present decisions.” In other words, you need to think about the intended and unintended consequences of today’s decisions. Want a couple of examples? Try these:

• DDT (easier to say than dichlorodiphenyltrichloroethane) was the very first modern pesticide and was widely used in crop protection and for the eradication of malaria-bearing mosquitoes in the 1940s and 1950s. The Swiss inventor was even awarded the Nobel Prize “for his discovery of the high efficiency of DDT as a contact poison against several arthropods.” Unfortunately DDT has toxic side effects and caused the death of fish and birds, so it was banned in many countries in the 1970s. Unfortunately, the banning lead to a resurgence of malaria in many tropical countries by the end of the 20th century. Was the widespread use of DDT a good decision? Was the wholesale banning of DDT a good decision? There may have been a better middle ground if scientists and politicians had looked into the future.
• Let’s look at today’s dire circumstances with “new” General Motors and consider just one of the many sets of decisions that brought the old GM to today’s condition. The relationships between management and the UAW have been rocky for a long time and both parties “bought peace” through contract language that provided unsustainable benefits for laid-off and retired workers. Unlike the DDT story, where the decision-makers may not have fully understood the science and biology involved, the long term impact of the contract language with GM and the UAW could have been seen by any good actuary and could have predicted the conditions facing both parties today. (Hmmm, did they?) Maybe the executives thirty  years ago knew fully well that they were laying the groundwork for a future problem. They just knew it wouldn’t happen on their watch.

So what do these simple stories have to do with you and your ability to make decisions? First, be careful when you’re dealing with situations that are novel and have yet-to-be-understood consequences. Go back to the skill of Observing and put a system in place to actively watch for early warning signs and be prepared to alter your decision.  Second, “run the numbers” well into the future for decisions that have quantifiable consequences and then use the skill of Challenging to test all assumptions. (Who knows, maybe GM execs in years past thought they made good decisions? It may be that their assumptions were overly optimistic.)  

Where have you seen organizations neglect to consider “the futurity of present decisions” and what have been the (unintended) consequences.

Last week I posted a comment about the Prepared Mind skill of Challenging. This week it’s about the need to improve our skill of Observing.

We admire those who are prepared for their future and wonder about those who plead “surprise” or try the tabloid defense of “I didn’t know.” Ignorance may be a defense in court – but what does that say about the person? Isn’t it the job of leaders to pay attention? Isn’t that something that’s required of all of us who are trying to get ahead in the era of accelerating change?

In the old days of the Soviet/American Cold War, the military recognized that getting surprised by Soviet bombers was not a good thing (to put it mildly) so we constructed the DEW (distant early warning) Line of radar sites along the northern horizon. The intent was to see danger as early as possible. Likewise, no one, not the CEO or the new data entry clerk, should be in the position of being surprised.

However, we don’t have the time or the bandwidth to notice everything. You can’t pay attention to everything!

So, one question you should ponder is that of “What worries you?”

We built the DEW Line because we were worried about the Soviets. We watch our cholesterol because we’re worried about heart disease. We watch “leading indicators” because we worry about the economy. So what should trigger your attention if it hits the edge of your mental radar screen?

What else should be on your “to be observed” checklist?

Well, think about all of the assumptions that are the foundation of our personal and business plans. Assumptions are great mental shortcuts; but they tend to degrade without warning. What assumptions did GM use until they found themselves in bankruptcy court?

You may assume that you and your department are valuable and necessary to the running of the organization in which you work. And, therefore, you maintain the status quo; just doing your job day-in and day-out. However, the current trend of outsourcing, sending knowledge jobs to China or India, should awaken you to observe specific trends in your industry. The bottom line is that you need to consider which of your assumptions are most important to your longevity and future success. Bring them into the open and watch them.

OK, so we need to observe those things that might put us at risk. How about the proverbial “flip side” of the coin? Where does opportunity lie? What was it that Toyota saw in 1993 that caused them to start the process that created the Prius hybrid? Why design, engineer and build a hybrid car when there was absolutely NO mass market? Simply put, Toyota saw the convergence of rising oil prices, and a rising world middle-class economy, and a citizenry concern for ecology. There was no market data to prove them right – only thinking driven by edge-of-the-screen observation.

Where are the opportunities waiting for your observations? And how do you prepare yourself to take advantage of them?

Ask yourself this question: “What can’t be done today that, if it could, would change your career or your company for the better?”

Can you see people in other disciplines, or companies, or industries that have already addressed your “impossibility?” You won’t know until you look and you won’t look until you decide to really observe the world around you.

You see, it all starts with intention. You won’t see the edge of your mental radar screen until you take the time to look.

Tell me what you see.

I have been fascinated with the quote attributed to the French biologist, Louis Pasteur, that “chance favors a prepared mind.” Consequently I wrote a book in 2006 with Jeanie Egmon from Northwestern University that focused on the skills (eight in all) we saw in leaders who were prepared for the future. (Go to www.PreparedLeader.com for an overview of the book and our thoughts behind it.) Anyway, given the level of uncertainty I see across the economy, I decided to return t that theme for a number of posts about getting ready for the future.

Here’s the challenge: Are you ready for the challenges and opportunities in your path from today to tomorrow?

Let me start with comments about the prepared mind skill of challenge.

We are pretty comfortable at challenging others’ thoughts and decisions. We’re sure that many authority figures (bosses, coaches, legislators, generals, etc.) are intellectual wimps and that we could do their job better than they. Sometimes we’re right. However, we’re often judging based on our biases, not our own ability to think well.

Everyone has opinions; are your opinions build on a solid foundation?How can you assess your ability to think and, consequently, challenge yourself to improve?

Try using Benjamin Bloom’s levels of cognitive ability. (Bloom was a U of C professor who studied thought processes that are used in learning. Google him to learn more.)

Bloom concluded that there are six levels of thought. Moving from the lowest to the highest they are: knowledge, comprehension, application, analysis, synthesis, and evaluation. At what level is your thinking? What underpins your opinions? Try the following example and then create some of your own.

Most of us know that General Motors is in a world of hurt, so let’s use their problem to understand the levels of thinking and to test our thinking.

• Knowledge – can you recall specific information? What are the products and services provided by GM? What nameplates have been eliminated? Which remain?
• Comprehension – can you state a problem in your own words? What is the major problem faced by GM and its unions as it emerges from bankruptcy?  
• Application – can you apply concepts to the “real world?” How has the labor contract trapped both parties? How does this apply to your workplace?
• Analysis – can you distinguish between facts and inferences? How is the  situation at Ford different from the situation at GM?
• Synthesis – can you put the parts together to form a whole, with emphasis on proposing alternative solutions? Can you design an organizational structure and new “social contract” that is agreeable to both management and unions at the new GM?
• Evaluation – can you judge and evaluate actions and outcomes based on a defined set of criteria? Maybe you love the government’s approach? Maybe you hate it. Here’s the tough question: What would you do to “fix” GM?

Maybe it was unfair to test your thinking about GM? What if I asked a similar set of questions about the war in Afghanistan? (Many of us hate it; but do we understand it?) What about your company’s strategy? (Why think about it? I’m sure “they” have everything under control.)  And then there are your views of our health care system. (“I’m sure it’s broken, but they need to fix it without raising taxes. It’s not my problem”) Hmmmm.

I now challenge all of us to move up the scale of Bloom’s levels of thought. We have plenty of knowledge and most of us are pretty good at comprehension. However, if my view of the world is representative of reality, we are sorely lacking in the widespread capability of the higher levels of this taxonomy.

The world of sound bites and “factoids” is a sterile world when it comes to good examples of the skills needed to synthesize and evaluate. What do you see? Are you worried?

My buddy Brad has suggested that I occasionally post something with a little “heft” to it. So, inasmuch as I’m working on a book project to help people become better prepared for the future of healthcare, I thought I’d point out the need for people to be better prepared for the future. Comments, please.

I collected articles and newspaper clipping about the world of healthcare providers. Here’s a sample and thoughts that try to go beyond the simple facts of the story and address the issues of being prepared.

·         “Medicare Won’t Pay Hospitals for Errors,” chicagotribune.com, February 18, 2008. The lay person reads this and says “Darned right!” Healthcare professionals think about the reality of dealing with human bodies and the near impossibility of taking these incidents to zero. A person who takes the time to think about the future wonders about the unintended consequences of this action.

One of the truisms of systems thinking is that all solutions inevitably create a new set of problems. Furthermore, these problems usually show up later and in different places. People prepared for the future have to consider the system of which they are a part and how that system reacts (predictably) to bending and breakpoint forces.

·         “Innovation in health care: An interview with the CEO of the Cleveland Clinic,” McKinsey Quarterly, March, 2008. The article explores an interview with Toby Cosgrove, MD, the CEO of the renowned Cleveland Clinic. In the article Dr. Cosgrove explains the three seismic shifts he sees in health care. The first is prevention; the second is the drive for value for dollars spent; and the third is that healthcare providers are being judged on the patient’s total experience, not just the clinical outcome. In order to address the third shift, he hired a chief experience officer “whose entire responsibility is to look at the hospital experience from the eyes of the patient and to translate that message back to the caregivers.”

Some hospitals have a tax status of “for profit;” others a status of “not-for profit.” But all hospitals are a business that competes for patients. Healthcare providers prepared for the future will consider their “value promise.” Why should patients come to your organization? Transparency of the total experience will only increase in the coming years, especially with the generation who “Googles” everything.

·         “Health Care that Puts a Computer on the Team,” The New York Times, December 27, 2008. The article describes the Marshfield Clinic an early adopter of health information technology and how it is a forerunner of medicine’s “digital future.” Much of the article goes onto explain the advantages of electronic medical records and how the Obama administration sees them as necessary. However, midway in the article it shifts to an examination of “predictive medicine” and the impact that it could have on the health of the population and the reduction of health care costs.

We’ve been down this technology road before and should know to think about the second and third order effects of a new technology. Leaders who are prepared for the future often have a great sense of the past.  The invention of radio did more than replace local singing groups – it enabled changes that ranged from national advertising to Blitzkrieg warfare. Electronic medical records will do more than replace paper records; and predictive medicine is only one of the more obvious effects. Be prepared for the future by learning how to “look across time” and really learn from history.

·         “How to Revive Health-Care Innovation,” Harvard Business School Working Knowledge, March 9, 2009. Clayton Christensen is a respected innovation guru and he has recently set his sights on evaluating the world of health care. He states that business model innovation, one of the three enablers of industry disruption, was common in health care until about thirty years ago. If he’s right, and we think he is, the current ranks of managers and executives are only beginning to feel the pressures of industry-wide disruptive innovation.

Leaders can prepare for the future of changes in their industry by analyzing the changes that other industries have experienced before them. Health care leaders like to remind us that “they don’t make widgets.” True; but human nature is pretty consistent, irrespective of the nature of the work to be accomplished. Do you want to prepare for the future health care innovation? It might not be a bad idea to analyze the reactions of people in industries ranging from automotive to consumer electronics to newspapers. Patterns emerge that might be helpful.

·         “Scalpel, suture and tweet: Surgery in 140 characters,” Chicago Tribune, April 8, 2009. The article explains how a spokesperson for a hospital in a Chicago suburb tracked the progress of an operation and sent “tweets” to a group of “followers.” Why? Because the hospital is experimenting with social networking as a marketing tool. Think this is silly? Questions came in from as far away as Switzerland.

Like it or not, different groups want different styles of communication. In a broader, more connected world, prepared leaders will have to flex to the needs of their stakeholders. Great thinkers always consider multiple points of view and what you see may not be comfortable. Like it or not.

·         “Virtual colonoscopy at center of policy debate,” Los Angeles Times, April 18, 2009. This article presented the pros and cons of paying for virtual colonoscopies and whether or not they are effective and saving money. Toward the end of the article the author explains that some studies have shown it to be pretty good but others “have suggested that it is not as good as detecting some smaller polyps.”

Ask yourself another question: “Is this as good as it will get?” Remember your first “car phone” or bag phone? How fast did they progress? Preparing for the future requires the ability to develop “impact maps” of current technologies and mentally play-out paths of progress. Die hard technologies generally assume the impact of a new technology sooner than it actually happens. But many of us get “surprised” by how fast technology progresses. Learning to assess varying “winds of change” is essential to thinking about the future. And technology is one of the winds affecting health care.

·         “Health care options focus on paying hospitals and doctors for quality, not quantity,” StarTribune.com, April 28, 2009. This was an AP article that gave an overview of the announcement of the Senate Finance Committee as they prepared to go into closed door discussions. In the announcement they quoted Senator Max Baucus, the Finance Chairman: “The key to healthcare reform is delivery system reform – reimbursing providers on the basis of quality, not volume.”  Here are our questions: How would a liberal interpret that sentence? What about a conservative? What about the CEO of a hospital? Without solid critical thinking skills that sentence is wide open to interpretation.

Now is not the time for uninformed opinions. Now is the time to think about the future and preparing for the future requires solid critical thinking skills. A key skill is the ability to ask GREAT questions. What assumptions are being used? What’s the scope of the “delivery system?” How does he define “reform?” He’s presented the problem in terms of a solution. What’s the real problem and what are the root causes of the problem? And on, and on. Preparing for the future requires an understanding of today and that requires more than opinions.

·         “A doctor in your pocket,” The Economist, April 18, 2009. The article explains how cell phones are being used in sub-Saharan Africa and part of Asia. The applications are simple, such as self-reporting and getting messages from a health care provider. However, the power of the story comes at the end when the article mentions the cell phones as part of a “global surveillance system” that can be used for prediction.

We have no data from the future. However, we have been blessed with imaginations. Unfortunately, many adults have disconnected their imagination in search of “the numbers.” Being prepared for the future requires a fertile imagination and adults need to rebuild what they had aplenty as children. Not only can it be done, it has to be done.

Healthcare will account for over 15% of GDP in the coming years.  What do you think they need to do to be prepared?