Friday, March 6, 2015

It's We

What I learned at the Workers' Compensation Research Institute's annual conference in Boston yesterday was a lot of what we basically already know - except well supported by data.

That's not a bad thing either.

We know, for instance that when you mess with medical fee schedules providers will find other ways to make up the revenue, such as with physician dispensing.

We know that some states have wildly different outcomes for similar injuries and have information to support why that occurs.

We know that medical care that is either unnecessary, not efficacious or perhaps harmful is related to financial incentives.

And we know that changing behavior in an entrenched system such as workers' compensation is enormously difficult.

But what do we do with this knowledge?

We can talk until we're blue in the face to legislators who make the laws that this industry is tasked with following, often times to our chagrin because we know better.

But they may not listen. They likely don't understand. Or they may be under the influence of some other group with a different outlook.

That's where Harvard professor Gary Orren came in - he was the guest speaker.

WCRI every year has someone come in from outside the work comp universe to tell us stuff that we intuitively know, but can't support with facts or data, and ergo workers' compensation as a consequence ends up the butt of federal government studies and nationally published general journalism.

Dr. Orren teaches politics and leadership at Harvard, and has taught for the past 45 years. His particular specialty is influence - getting people to do something they otherwise wouldn't do.

His lesson has every day application to what we do.

Influence, Orren says, is the product of the Three Ps:
Power - which is making a command assertion:
Pnegotiation (the "p" is silent, Orren joked) - haggling, trading, exchanging, or otherwise engaging in reciprocity:
Persuasion - inducing behavior through communication.

True influential behavior engages all of the three Ps. There are times when it is appropriate to make a command decisions. There are times when something needs to be negotiated in order to get "buy in." And there are times when just saying the right thing at the right time seals the deal.

The Three Ps work in concert.

There is a common denominator in the Three Ps: listening: the best way to learn is to absorb information that is unfamiliar and outside our knowledge, that is when our brains are most sponge like.

But you have to stop and actively listen.

Orren used a clip from the movie Gettysburg where Corporal Joshua Lawrence Chamberlain used the Three Ps to persuade a group of 114 out of 120 "mutineers" to rejoin the Union's efforts in the Civil War in the Battle of Gettysburg; a key tactical point in the war.

Joshua Lawrence Chamberlain

And without these 114 mutineers joining the fight historians are generally in agreement that not only would the North have lost the battle, but likely would have also lost the war.

Emotional control is a part of listening. Many want to respond immediately because there is an emotional attack.

But in order to successfully persuade without causing harm or damage to the other person or to yourself you need to know the argument, and fundamentally learn what the problem is.

Chamberlain, Orren pointed out, understood that the mutineers had grievances,  and he learns by listening and controlling his emotions so that he does not respond ineffectively, that their grievances are about dignity, respect, and being treated like a human.

It was not about "the Papers," i.e. the orders the mutineers were detained under. The reason they were mutineers was because their prior leaders did not value them. What Chamberlain heard was, "we work hard, how about some respect, how about valuing us as people."

The example was poignant - doesn't it sound like what we hear from the injured worker population?

People who are good at persuasion have an understanding and knowing of the audience, you can't know them too well.

Chamberlain quickly understood, by listening and not lashing out, that what mattered most to the mutineers was being shot for treasonous behavior, and Chamberlain tells them he's not going to do it - they may get shot by someone else, but it wasn't going to be under his orders.

Chamberlain relied on what he and the mutineers share in common; how are we the same? The similarities: all have seen men die, all are volunteers and all are from Maine, all share the ideal of freedom and that to free other men means having to fight together, fighting for each other.

It's about "we" and doesn't get personal (Chamberlain doesn't use "I") until a commitment, a promise, an act of trust, is made: "We work together and I promise a result and will personally see that result occur."

So when we go about our daily jobs executing the Grand Bargain we need to remember that "we" are all in this together.

If people didn't get hurt at work, we wouldn't be doing the job of ensuring their welfare.

If the work that employers bring to the economy didn't have some risk, we wouldn't have jobs spreading that risk and minimizing impacts on business.

It's not us versus them.

It's "we." We're all part of the Grand Bargain.

That message gets lost, perhaps too often. But my guess is that "successful outcomes" have more to do with listening with respect and dignity than any commands we may execute.

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