Almost two months down, ten months to go. The sun is shining, the air is bright and the buds on the trees are starting to unfurl. It feels like spring is on its way. Recently on a walk through the city, the street musicians were back, people were out in droves and for the first time, in what seems like forever, there was happiness and light in the air. It felt as though people have finally stopped holding their breath as they wait for more bad COVID news, and have started to dare to hope for the end of the pandemic restrictions and, indeed, of the pandemic itself. People have started to live again. I felt a glorious rekindling of hope.
– The hurrier I go the behinder I get – the March Hare on projects
– Rising to the challenge – on how to think differently about your team
– Change comes from the inside – on why to say no if someone asks you to just tell them what to do
– Patients, pills and monitoring compliance
The Hurrier I Go the Behinder I Get – the March Hare on Projects
It is almost March, which means there are only 10 months left for project delivery in 2022 and, as I adore Alice in Wonderland, the March Hare’s “the hurrier I go the behinder I get ” is fitting. Most projects are evaluated, discussed, budgeted and contracted, often for months, before approval. However, delivery timelines are rarely moved back. Teams work under pressure, tempted to cut corners. Delivering a good outcome in this situation is hard. I’d argue that if a project will enhance your service, increase customer satisfaction, offer a competitive advantage and improve market insights, or other equally important KPIs, then the longer you wait the more ground you lose. So, if you are sitting on a project, don’t wait until Easter for it to hatch, best get cracking! If in doubt, do a baseline assessment of the KPIs. If you need help with that, I am happy to have an informal chat.
Rising to the Challenge – Moving from a Mindset of Poverty to one of Abundance
I read cookbooks to relax. Currently, I am reading about bread ingredients: yeast, flour, salt, water sometimes oil, plus seeds, spices etc. I am captivated by the thought that just by being handled differently these humble ingredients can be made into a huge variety of exciting breads: leavened and unleavened, fermented, sweet, enriched, festive. What if we were similarly open-minded about the individuals we work with? What if we remember that in the right environment, with the right leadership we can coax the most amazing results from the same stable team? What if instead of having a mindset of poverty: this is all I have to work with. We had a mindset of abundance: this is the team I have to work with, these are the individuals, let’s see what marvels we can create together. Often, we are limited not by reality but by our inability to see what is possible.
Change Comes from the Inside – on Why to Say No if Someone Asks you to Just Tell Them What to Do
A coachee once said to me “Isabelle, this is my situation, can’t you just tell me what to do? ” The answer is, of course, no. Not if you want a sustainable outcome, not if you want a real change. Often individuals are told that they need to change. For example, a manager once told me, that my presentation skills in German needed work. I asked for pointers. Her response? “No, I am not qualified to give you any, I am not a presentation expert ”. In general, I’d recommend having something to illustrate your feedback when telling an employee they need to change – but I digress.
However, in that instance, I knew what the issue was. I came to German later in life and presenting in it never feels totally natural. It’s like wearing a pair of very tight Latex trousers (or any Latex trousers really) and we never really hit it off. The solution then was easy. I knew my key driver for the discomfort: I prefer multicultural, international work environments and English is my comfy, Wellington boot language. Hence, today I mostly work in English.
The moral of the story? While you can tell someone they need to change a behaviour, unless they understand what drives it, it’s impossible to influence. And unless there is a benefit to them in changing a behaviour, it is hard to address. Different situations call for different solutions, and each solution is unique to the individual because change comes from the inside.
If you tell someone how and what to change, but don’t help them understand what drives them, it is like painting the door of a rusty fridge. It looks good for a bit until the rust breaks through. As soon as something stressful happens, if you address only the conscious behaviour, your coachee, even with the best intentions, will revert to type.
Patients, Pills and Monitoring Compliance
Patients, we are told, are not compliant. They don’t understand why to take a medication as prescribed. Or they simply forget. Or they have other reasons for “not doing as they have been told”. Enter digital solutions: the pill box that chimes, the app that pings at you, the pill that is digitally enhanced so the hospital can track whether you took it or not. At some point it is likely that payors will mandate the use of digital compliance checks for certain products as a condition of paying for them. Once again, we are fixing a systemic error by treating a symptom, when what we should be asking is, “why are some patients not compliant? ” The reasons vary, for example, a patient on statins told me, “Oh, I only take it every other day so that my body can recover from the toxicity ”. It seems reasonable to postulate that many patients are not compliant because they do not understand how the medicine they are taking works, or the impact of the illness that is being treated, if left untreated.
We know that doctors have less time than ever to talk to patients. In many health systems, doctors who treat multimorbid patients are penalised for “just talking”. Multimorbid patients are often older and have complex treatment schedules. So, I believe, another systemic error is being blamed on the weakest link. The solution to the compliance problem is not to monitor compliance digitally under the header of “we are naturally doing this for the patient ”, it is to address the underlying issues.
Questions we could ask to better address challenges with compliance: can we link compliance to the time a patient spends talking to the doctor when the medicine is first prescribed? Is compliance worse in health systems that reward doctors for “doing things to patients” rather than speaking to them? How different is compliance between patient populations? Data suggests compliance is a bigger challenge in conditions where a patient feels fine without the medicine, and worse when on it. Is that generally true? Could we stratify compliance by the treating physician? Is it unreasonable to expect that the HCP is also a variable that could be looked at in patient compliance? I think not.
In conclusion, technology is never the solution; it is only something we can use to support what we do. As always, it is harder to address the root cause, but if you merely treat the symptoms without a diagnosis, you cannot solve the issue. Sadly, fast and easy is hardly ever the way to go.
I look forward to hearing your thoughts. And of course, if you have a challenging project or would like to discuss coaching to help you achieve that next level, do reach out and we can arrange to chat.
Very best wishes
Isabelle C. Widmer