Category: Commentary & Opinion

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13 Questions to Ask On-Site Clinic Vendors

Thinking about opening a primary care clinic at your business site? Many organizations are.


Work-site medical clinics are catching on as employers discover they can save significant dollars and improve the care for their employees and families. Clinic vendors’ medical management and business models vary dramatically, however, and, as a result, so do their impacts on cost and quality.


Though on-site clinics have been around for more than 25 years, the designs have evolved. Some older clinic vendors offer elaborately expensive facilities with conventional doctor office arrangements, which makes it difficult to deliver savings. By contrast, contemporary vendors are more likely to heavily invest in tools and programs, creating comprehensive medical management platforms.


Demand for work-site primary care clinics is a response to the failure of medical providers and health plans to cost-effectively manage and improve the health of patients. By bringing a clinic to the work site, the employer offers the clinician a deal. The employer pays more than the doctor or nurse can typically make in private practice, with conditions very different than the gerbil-on-a-wheel circumstances in which many primary care clinicians now practice.


In better clinics, the doctor or nurse sees fewer patients and spends more time with each one. There are state-of-the-art electronic health records and clinical-decision-support tools. But best of all, the primary care clinician has the authority to reach out to and collaborate with specialists on each referred patient’s care, acting not simply as a “gatekeeper,” but as the patient’s advocate and guide. In exchange, employers obtain healthier employees and families at lower cost.


How can you evaluate which clinics are the best? Here are some questions and rationales to help identify clinic vendors that are most likely to provide the best possible experience, quality improvement and savings.


1. Is the clinic led by a primary care physician or a nurse practitioner? Primary care physicians cost more and nurse practitioners can be very effective, but here are two cold truths. First, specialists are more likely to collaborate with physicians, facilitating coordination of care. Second, if a key clinic goal is creating what’s called a “medical home” and moving the locus of control inside the clinic, a clinic physician can supplant the health-plan network doctor. A nurse practitioner, on the other hand, is only likely to supplement the care provided by the health plan’s primary care physician. In the end, the extra investment for a physician-led clinic will pay itself back many times over. And most well-configured physician-led clinics still make very effective use of nurse practitioners.


2. Are the lead clinicians encouraged to collaborate with specialists? Do they have the authority to do so? One of managed care’s mistakes was relegating primary care physicians to gatekeepers. Specialists have a financial incentive to provide unnecessary care services to referred patients, so it is important to urge primary care physicians to reach out to specialists and insist that they manage the patient collaboratively. Of course, as the referring physician, the primary care physician carries a veiled threat that a refusal to work together will end the referral stream. Some vendors have seen dramatic drops in specialty utilization as a result of this approach. Ask each clinic vendor how specialty referrals are handled.


3. Who manages the clinic’s clinical and business functions? Believe it or not, some clinics are managed by health insurance brokers with no clinical background. Are experienced clinicians overseeing the clinic’s medical management functions? Are experienced clinical operations professionals managing the clinic’s business processes? What mechanisms are in place to ensure consistent quality across the clinic vendor’s enterprise?


4. Does the vendor mark up products and services, or simply pass through the documented costs of the clinic and charge a management fee? A big driver of excessive health care cost is fee-for-service reimbursement—payment for each product and service. This kind of reimbursement encourages more care, independent of whether it’s the right care. Clinic vendors that profit from every service have an incentive to provide as many services as possible. The alternative approach has the client pay exactly what it costs to run the clinic—for staff time, drugs, labs and office supplies—and then pay a separate management fee. This approach discourages the provision of unnecessary care or the denial of necessary care.


5. Do the clinic’s owners have financial conflicts of interest? Clinics owned by hospitals, for example, may have an incentive to send patients to their hospitals to fill their beds and diagnostic slots. This is why they purchase primary care physicians’ practices: to serve as feeders. Unless they represent other interests, such as pharmacies or laboratories, independently owned clinics are not financially conflicted in this way.


6. Do employees and their family members have to pay to use the clinic? Employers invest in inexpensive primary care as a way of warding off expensive specialties and inpatient settings. If the clinic’s goal is high participation, then it makes sense to lower or eliminate patient fees. Clinics with free visits—as well as free standard drugs and laboratory tests—develop higher participation. This has a greater impact on lowering health care costs later. Make it easy for employees and their families to receive preventive services, and you’ll eliminate both higher rates of specialty referrals and escalating problems that may result in expensive emergency visits later. Sure, some executives may sniff and say that they would only go to their own private physician, but free care is a no-brainer for most working families.


7. Are on-site face-to-face disease management, wellness and prevention services available? Two-thirds of most employers’ health expenditures come from lifestyle-related chronic disease such as diabetes, hypertension and asthma. A decade of in-the-field disease management experience and literature have shown that call-center approaches are mostly ineffective. What works, instead, are repeated, face-to-face interactions with a clinician whom the patient trusts. Effective clinics will have a nurse on site who works with chronically ill patients and provides routine wellness/prevention education and support in smoking cessation, cooking and nutrition education, and fitness.


8. Does the clinic have Web-based health information technologies? End-to-end health information technologies are necessary to optimally manage patient and employee care. These technologies should include analytical tools to identify patients with chronic disease and those who are likely to have a major acute condition within the next year. Care-gap analysis and other clinical-decision-support tools help physicians deliver the right care at the right time. Patients should be able to make appointments online and get access to their personal health records so they can become more engaged with their care. Electronic health records track patient information and let the organization measure the achievement of targets, so you can understand whether the clinic is improving care quality for your group. Clients’ claims, drug and lab data can be merged with electronic health record data to provide a more complete picture of the patient’s experience, and to allow an understanding of the clinic’s impact on the full continuum of care. All these capabilities should be Web-based, rather than relying on old-fashioned client-server technologies. Web-based tools cost significantly less and are more effective.


9. Does the clinic provide both personal (i.e., group) health and occupational health services? A clinic requires significant infrastructure. But once implemented, it can work for both personal and occupational health issues. This is significant, because occupational health services include five major areas that are worth two to three times the value of the group health premium. These are workers’ compensation primary care, lost work time, disability management, the clinic’s value in the retention and recruitment of employees and the ability to do on-site human resources testing (such as drug screens and Department of Transportation exams). Of course, allowing the clinic to perform double duty requires some additional process and cost, but the greater investment is dwarfed by the potential impact for savings.


10. Is the employer indemnified against medical liability? Clinicians should carry medical malpractice insurance, of course. But the vendor should also carry medical malpractice coverage on all of its clinicians. Vendors that simply expect their clinicians to buy their own coverage add an unnecessary layer of risk: What if a clinician allows a lapse in his coverage? In the end, you should expect to be indemnified to the greatest degree possible. The buck should stop with your vendor.


11. Has personal health information been made private and secure? No employer wants to learn that personal health information has been compromised. Ask for detailed, audited proof that the vendor has secured all privacy- and security-related processes.


12. Are the vendor’s reports complete and transparent? How is the vendor accountable to you? Ask to see the vendor’s reports on clinic use, cost, quality and financial impact. Is supporting documentation available? All costs and relationships involved in bringing the clinic’s operations to fruition should be visible to you. All analytical methods should be transparent, so the client can easily understand how measurement values were derived. Past behavior is the best predictor of future performance.


13. Can the vendor supply testimonials and solid data on past performance? Many vendors have heartwarming stories and claims of effectiveness, but when pressed, they can’t actually show that they save money. To produce consistent return on investment and quality improvements, there must be a careful balance of streamlined operations, effective medical management and continual focus on value. Don’t take the vendors’ word for it. Demand clients’ reviews and actual clinic performance data, not speculative projections extrapolated from average savings reported in the literature.


On-site clinics are a transformational trend in American health care because they create closed systems with revised rules for care management and reimbursement. Properly configured, clinics can cut 15 percent or more from a group’s total health care expenditure, net of the clinic’s cost. But on-site clinics need to be understood as complex machines, comprising a variety of mechanisms that aspire to the right result for the patient and the purchaser every time. By asking careful questions about these approaches upfront and demanding straightforward answers, you can avoid regrets later.


Workforce Management Online, February 2010 — Register Now!

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More Firms Paying Mind to Mentoring

It may turn out to be just a New Year’s resolution, but an increasing number of U.S. companies appear ready to adopt mentoring programs in 2010 as a way to develop up-and-coming leaders.


Nearly one in five companies plan this year to initiate some type of mentoring or coaching to help top employees make the transition to leadership, according to a study by Boston-based Aberdeen Group.


Seventy-six percent of companies surveyed said they have used mentoring in an effort to deliver critical leadership skills. Nearly two-thirds said they find mentoring to be effective. Twelve percent found it ineffective.


The report, “Learning & Development: Arming Frontline and Midlevel Managers to Deliver People and Performance Results,” collected responses from about 500 human resources professionals, corporate directors and business managers. Aside from mentoring, participants were asked to rank various learning approaches by effectiveness, including instructional classes, synchronous and asynchronous learning, online tools, mobile learning, on-the-job training and social networking.


It is not likely that every company will follow through on its stated desire to launch mentoring within the next 12 months, says Kevin Martin, a vice president with Aberdeen’s human capital management practice. But Martin says organizations are very serious about the value of mentoring because it helps to address their most pressing concern: figuring out how to capture and share key organizational information as veteran leaders near retirement.


“Companies are expecting a massive brain drain when the economy rebounds. Mentoring and coaching are great ways to teach people and transfer your intellectual capital before it leaves the organization,” Martin says.


A related concern is keeping younger employees from leaving because they see a chance to advance more quickly elsewhere. Pairing them with senior leaders is a proven way for a company to retain its most promising workers, Martin says.


The latter point is borne out by a December survey from Opinion Research Corp. in Princeton, New Jersey. It found that 25 percent of employees plan to leave their present employer when the job market improves. Employees ages 18 to 34 are the most likely to change jobs.


Aberdeen’s research noted that companies that are using mentoring appear to be doing so almost offhandedly. Although roughly two-thirds of companies use it, only 26 percent of them formally assign mentors to newly promoted managers. That may soon change. Martin says 40 percent of survey respondents plan to put formal programs in place this year.


In February, Aberdeen is due to release a report on onboarding that Martin says affirms the crucial role mentors will play in the future. Each employee can give a finite amount of effort, so expecting them to work harder is not a feasible strategy. As employee effort hits a plateau, so too does business performance.


Martin says mentors will be asked to harness employees’ efforts and steer them in the direction of concrete, measurable business goals. He says it will be the overriding business issue for companies in 2010.


“It’s how companies are going to get incremental business results, without adding incrementally to their workforces,” Martin says.


Workforce Management, January 2010, p. 10 — Subscribe Now!

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Migrant Workers Injury in Company Housing Ruled Compensable

A fractured ankle a migrant worker received while living in employer-provided housing arose in the course of employment and is compensable, the South Carolina Supreme Court has ruled.


The decision Tuesday, February 16, in Frantz Pierre v. Seaside Farms Inc. and American Home Insurance Co. overturned rulings by the South Carolina Workers’ Compensation Commission and a circuit court, which decided that Pierre’s 2003 ankle injury was not compensable because he was not at work.


The accident occurred the evening before his first day of work.


The commission and lower court also found that the seasonal worker hired to perform duties in a packing house was not required to live in the employer-provided housing, which court documents describe as a tin-roofed barracks.


But the South Carolina Supreme Court disagreed in remanding the case for further proceedings.


It said that Pierre’s injury, which occurred when he fell on a sidewalk where water was flowing from an outdoor sink used to wash clothes, occurred as a result of a hazard on his employer’s property.


“Thus, the source of the injury was a risk associated with the conditions under which the employees were required to live,” the state Supreme Court ruled. It also said Pierre essentially was required to live on the grounds because he and other migrant workers employed by Seaside “did not earn enough to obtain housing, and short-term rentals that coincided with the time they would be in the area did not exist.”


In addition, the nature of the job required workers to live near the packing facility and the living arrangement was convenient for the employer’s work schedule that varied with weather and crop conditions.


In reaching its conclusion, the South Carolina Supreme Court cited similar decisions in Florida, New Mexico and Oregon that relied on a “bunkhouse rule.”


“We find the reasoning in these cases persuasive and that they represent the modern view in employee-residence jurisprudence,” the South Carolina high court ruled.


 


Filed by Roberto Ceniceros of Business Insurance, a sister publication of Workforce Management. To comment, e-mail editors@workforce.com.


 


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The Last Word Accentuate the Positive

OK, we’re past the New Year’s festivities, the NFL playoffs and Super Bowl and well into 2010. So, I’m dying to ask—are you feeling the economic recovery yet?


If you’re honest, the answer is probably something along the lines of “not really.” If you’re fortunate—that is, if you work in one of the rare industries actually seeing an uptick—perhaps you can say, “Well, we’re feeling it, but just a little bit.”


The fact is, we still have more than 15 million people unemployed, the national unemployment rate is 10 percent and the economy isn’t creating many jobs. Larry Summers, an economic advisor to President Barack Obama, told the World Economic Forum in Davos, Switzerland, last month that we’re experiencing a “statistical recovery and a human recession.”


In other words, any near-term growth in your business or organization is going to come from getting more out of your current workforce, and the best way to get more out of your workforce is to get them more focused and engaged.


I wrote here last fall that a fairly simple way for managers to help get their organizations out of this economic morass is to focus more on engaging their employees. And I listed some ways to do this: more communication from the top, some sense of when all the pay freezes and furloughs might end and a greater recognition (and appreciation) of the sacrifices everyone has been making to get through this recession.


As simple as that sounds, there may be an even easier way for managers to engage workers, as this Workforce Management story makes clear—by just focusing on the strengths of your employees.


Some newly released research by the Gallup organization found that employee engagement, which is the increased discretionary effort you get from workers who feel passionately connected to their jobs, rises considerably when managers focus on employees’ strengths.


Of course, workers are a lot less engaged when the manager focus is on their weaknesses. That’s not a big shock, but what was a surprise is the finding that employees are hardly engaged at all when their managers instead simply ignore them.


This is important information, the authors of the Gallup survey said, “because employees who are ignored feel like they don’t matter. There’s a crucial phenomenon inherent in employee engagement: The best employees don’t want to be coddled; they want to matter. They want to be part of something greater than themselves. … [A]lthough it seems counterintuitive, when managers focus on weaknesses rather than ignoring employees, those employees’ chances of being engaged actually improve. That’s because people prefer to get any feedback over no feedback at all—even if that feedback is criticism.”


I’ve worked for a few of those bosses who seem to ignore the people under them, and I always wondered: How do these yahoos get promoted into management, anyway?


That’s something the Gallup survey didn’t focus on, but anyone who has spent much time in the workforce knows that it’s disconnected managers who create the most disengaged workers.


Some would say that employee engagement is valuable to an organization no matter what the economic environment is, but the reality is that in good times, great employee engagement is a bonus, the icing on the cake, an added dimension.


In really tough times, like those we’ve experienced for the past 18 months, employee engagement is crucial. It may be the only way you can help get your business to the point where, eventually, you can hire again. You can’t get there without managers who focus on employee strengths and build on them.


The late, great management guru Peter Drucker used to say that “to focus on weakness is wasteful—a misuse, if not abuse, of the human resource.” Drucker was right, as usual. Focusing on what people do right is the way to get more of what’s right out of them. Smart managers will take that credo to heart. It may be the only way to keep your organization moving onward, upward and, eventually, out of the Great Recession.


Workforce Management, February 2010,  p. 50 — Subscribe Now!

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Why Forcing Managers to Interview Minority Candidates Is Good Business

If you follow sports, you’re probably aware that Pete Carroll, former head football coach at the University of Southern California, left the school to become the head coach of the National Football League’s Seattle Seahawks. On the surface, this is pretty pedestrian stuff, as a head coach with a national title at the college level getting a chance at a big payday in the pros happens frequently.


What you probably don’t know is this: Before the Seahawks and Carroll could sign a contract that had already been agreed to verbally, the Seahawks had to interview at least one minority candidate as part of the process. It’s required in the NFL, and here’s how the rule (known as the Rooney Rule) is positioned, according to lawyer/writer Jack Oceano:


“Under the NFL’s Rooney Rule, any team in the National Football League offering a head coaching position must interview at least one minority candidate. Named after the Pittsburgh Steelers owner Dan Rooney, chairman of the league’s diversity committee, the rule was created in the hopes of increasing the number of minority head coaches in the league.”


How do you feel about that? There’s nothing that gets the blood flowing on all sides like a situational hiring analysis with an affirmative-action feel. Since I’m pro-employer on most issues I tackle, you’ll more than likely be surprised by my take on the Rooney Rule: I think it’s a good business practice.


Before you decide to hate me or unsubscribe to my blogs, allow me to explain.


To effectively think about this scenario and strip the emotion out of the issue, you have to stop talking about affirmative action and start talking about how the world of hiring works. To do that, let’s replace “minority candidate” with “internal candidate” and evaluate the general merits of forcing interviews even if it seems the decision has already been made.


Many companies struggle with forcing managers to interview internal candidates for posted positions, with the struggle usually emerging as follows:


1. The position is posted, and the hiring manager is looking for a purple squirrel. That means the hiring manager has no confidence that any internal candidate can do the job. He needs the best and believes that the necessary talent can be acquired only outside the company.


2. On many occasions, hiring managers have an external candidate in mind they want to plug into the job. When this happens, they’re usually so set on the decision that they think any other interviews are a waste of time. The tough part about this is that your company still has a process, and the hiring manager needs to put forth a little more effort to keep everyone happy.


3. Your hiring manager has an external candidate, but you’ve also got three internal candidates who have applied for the position. Your company has a process that says all internal candidates are, at the very least, going to get a brief conversation/interview with the hiring manager in question. Your hiring manager doesn’t want to do it, and he’s bitching about it.


4. You’re faced with the classic Catch-22 in this situation. You either force the process with the internal interviews and risk looking like a complete bureaucrat, or you let the hiring manager do his thing without interviewing the internals, which is decidedly bad for your culture and employee relations.


Recognize this morality play yet? If you’ve been anywhere near the front lines of a hiring process in corporate America, you’ve lived it. With a name like The HR Capitalist, you might think I would allow the hiring manager to skip the internal interviews, right? I don’t, and here’s why:


1. I’ve learned that for every 10 internal interviews you make a hiring manager perform against their will, they are going to get two or three pleasant surprises. They had no clue about the experience Lisa from marketing had in their new target sector. Lisa’s résumé doesn’t capture it either, but because you forced the interview, the resulting dialogue made both parties aware they had a much better match than previously thought.


2. When those internal surprises happen, good things follow. It might mean the hiring manager was impressed enough by the candidate in question they’ll change their mind and offer them the job. Maybe they’ll keep that candidate in mind and hire them for a future role. Perhaps they’ll refer the person to others in the organization.


Regardless of the outcome, your organization wins by forcing internal interviews for candidates who apply. My stance on internal interviews is easily carried over to the Rooney Rule. By forcing interviews of minority candidates, you’ve got a shot to make the hiring managers go, “Hmmm.”


Need proof? Look no further than when Mike Tomlin became the head coach of the Pittsburgh Steelers at the young age of 34 (and later led the team to an NFL championship). This from an ESPN.com story:


“Mike Tomlin wouldn’t have gotten this opportunity without this rule,” said [Art] Shell, the first modern black NFL head coach. “He never would have sat down with Dan Rooney.”


Said Rooney: “To be honest with you, before the interview he was just another guy who was an assistant coach. Once we interviewed him the first time, he just came through and we thought it was great. And we brought him back and talked to him on the phone and went through the process that we do, and he ended up winning the job.”


The Rooney Rule and a progressive approach to internal candidates accomplish the same thing: They put the best people in the interview mix. You don’t put rules on interviewing minorities or internal candidates in place because it’s the right thing to do. You do it because the exposure gives strong talent an opportunity to surprise hiring managers who wouldn’t otherwise be exposed to them.


And that, my friends, should be our main objective in the talent game. Whether you’re in the front office of the NFL, looking for someone to manage the IT shop at your consulting firm or looking for a line manager at your plant, you always win by forcing some interviews. Don’t be intimidated by being called a bureaucrat. You’ve got bigger goals in mind.

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HHS Secretary Asks Insurer to Justify Rate Hike

Kathleen Sebelius, secretary of the U.S. Health and Human Services Department, has called on Anthem Blue Cross of California to release financial data to justify its 39 percent increase in premium costs for California customers with individual policies. President Barack Obama cited the increase to bolster his case for health care reform. The rate increase does not apply to employer-provided plans.

In a letter dated February 8 and sent to Anthem Blue Cross president Leslie Margolin, Sebelius said she was “disturbed” to learn about the increase, which she said is 15 times greater than the rate of inflation and could make insurance unaffordable for hundreds of thousands of Californians.


“Your company’s strong financial position makes these rate increases even more difficult to understand,” the secretary stated, adding that WellPoint, Anthem’s parent company, posted $2.7 billion in profits during the fourth quarter of 2009.


Sebelius also called on the company to make public its medical-loss ratio data, or the amount of premiums that is used for medical care versus the percentage used for administrative costs.


California law requires that insurers spend at least 70 cents of every premium dollar on medical care.


Last week, California Insurance Commissioner Steve Poizner instructed his department to hire an outside actuary to examine Anthem’s rates, adding that if the ratio is found to be excessive, “I will use the full power of my office to bring these rates down.”


An Anthem spokeswoman said that the company had been alerted to Sebelius’ letter through media accounts, but has yet to review it.


In a statement on its rate increase, Anthem said that the rising cost of care has forced the company to raise its premiums.


“It is important to note that premiums are expensive because the underlying healthcare costs are expensive,” the letter states.


Filed by Matthew DoBias of Modern Health Care, a sister publication of Workforce Management. To comment, e-mail editors@workforce.com.


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NLRB Nominee Fails to Assuage Business Community

A controversial nominee for a panel that oversees private-sector collective bargaining distanced himself in a Senate hearing from articles he authored that question whether management can participate in union elections.


The appearance by Harold Craig Becker on Tuesday, February 2 before the Senate Health, Education, Labor and Pensions Committee failed, however, to assuage corporate concerns that he will try to implement through administrative means labor law changes contained in a bill that is stalled on Capitol Hill.


The Senate labor committee is set to vote Thursday, February 4, on Becker’s nomination to the National Labor Relations Board. Action by the full Senate may come as soon as next week.


“We will have this as expeditiously as possible on the floor,” said Sen. Tom Harkin, D-Iowa and chairman of the committee.


Business groups assert that Democrats are trying to get Becker confirmed before Sen.-elect Scott Brown, R-Massachusetts, is sworn into office. Brown, who won a special election to replace the late Sen. Edward Kennedy, will be seated on February 11.


Harkin said he “bent over backwards” to accommodate Republicans by holding the hearing. NLRB nominees usually don’t appear before the committee.


When Brown enters the Senate, the GOP ranks will increase to 41, enough members to sustain a filibuster. Another nominee who has met Republican resistance, Patricia Smith, tapped as Department of Labor solicitor, survived a filibuster attempt on Monday, February 1, and appears set for Senate approval this week.


The Becker nomination was halted last year when Sen. John McCain, R-Arizona, placed a hold on it. Becker was renominated by President Barack Obama in January.


At the hearing this week, McCain expressed frustration with Becker but did not indicate whether he would stop blocking the nomination.


Senators questioned Becker about a 1993 Minnesota Law Review article in which he wrote that “employers should be stripped of any legally cognizable interest in their employees’ election of representatives.”


Becker opponents argue that such assertions foreshadow the way that he would try to implement provisions of the Employee Free Choice Act through NLRB rulings. The board will have a 3-2 Democratic majority if Becker and two other nominees are approved.


The Employee Free Choice Act, which is stuck in the Senate as supporters seek the 60 votes required to break a filibuster, would allow workers to organize by signing authorization cards. Under current law, employers can insist on a secret-ballot election supervised by the NLRB.


If confirmed for the NLRB, Becker said that he would adhere to labor law. He argued that his writings were an academic exercise meant to provoke debate. Becker, who is associate general counsel for the Service Employees International Union, has served as a professor at Georgetown University, the University of Chicago and the University of California, Los Angeles.


The tall, lanky, soft-spoken Becker looked the part of an academic at the hearing. In calm, measured tones, he explained that he understood the difference between being a scholar and serving as an NLRB adjudicator.


“Part of that [NLRB] role is to respect the will of Congress,” Becker said. “The law is clear that … an alternative route to certification rests with Congress. It’s clear that employers … have an indisputable right to express their views on whether employees can unionize.”


Those words provided little comfort to the business community.


“The bottom line for us is that there are still a lot of unanswered questions,” said Michael Eastman, executive director of labor policy at the U.S. Chamber of Commerce. “The NLRB has a ton of room to regulate. What parts of employer free speech would he believe should be prohibited?”


McCain continues to have issues with Becker, questioning him about potential conflicts of interest involving the SEIU.


Becker responded that he would comply “scrupulously” with an ethics pledge to recuse himself from SEIU lawsuits for two years.


“That’s not good enough,” McCain said.


Although McCain could place another hold on Becker’s nomination, Harkin is determined to press ahead. He dismissed accusations that Democrats are rushing the nomination.


“That’s nonsense,” he said. “We’ve had this nomination since last July. He’s already been voted out of this committee with two Republican votes.”


If Becker is confirmed, it’s inevitable that the NLRB will be more union friendly under a Democratic board majority.


That doesn’t mean, however, that it can implement aspects of the Employee Free Choice Act on its own, according to Erin Johansson, senior research associate at American Rights at Work. A Democratic NLRB under President Bill Clinton didn’t institute card check.


“If it could have been done, it would have already,” she said.


—Mark Schoeff Jr.



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Solis Defends Labor Dept. Focus on Enforcement

Labor Secretary Hilda Solis defended her agency’s emphasis on enforcement against Republican charges that regulations hinder job creation at a Capitol Hill appearance on Wednesday, February 3.


In testimony before the House Education and Labor Committee, Solis touted an increase in the number of investigators conducting reviews of private-sector safety and pay practices. The Obama administration budget  released on February 1 restores the enforcement staff to its 2001 levels.


Solis argued that it is imperative during tough economic times to crack down on employers who cheat workers out of wages and permit unsafe work environments.


“One way of combating that is to make sure we have troops on the ground,” she said.


She implied that enforcement was lax during the eight years of the George W. Bush administration. She compared reorienting the large agency to changing the direction of an aircraft carrier.


“We’re turning things around in the Department of Labor,” Solis said. “We’re moving every single day. Our rudders are on.”


Worker training also is a priority, according to Solis. She said the Obama administration supports reauthorization this year of the Workforce Investment Act, the law that governs many postsecondary training programs. The administration also is seeking to make the federal training system more streamlined, innovative and responsive to local hiring needs, Solis said.


Republicans on the committee are concerned that the agency—and, more broadly, congressional Democrats—will run business aground with new rules and regulations.


Rep. Phil Roe, R-Tennessee, said that employers in his district are hesitant to expand because they’re leery of the potential bottom-line impact of Democratic proposals to strengthen unions and overhaul the U.S. health care system.


“They don’t know what their costs are,” Roe said. “[The Labor Department is] hiring, but small businesses aren’t hiring.”


Solis also spent time defending the administration’s $787 billion stimulus measure, which Republicans ridiculed for failing to halt a rise in the unemployment rate from 7.7 percent in January 2009 to the current 10 percent.


“The American people want to know: Where are the jobs?” said Rep. Tom Price, R-Georgia.


Solis said that the recovery package “has made a difference,” citing an administration report that it has created 640,000 jobs. She also asserted that infrastructure spending, such as a high-speed rail project in Ohio, will continue to foster employment after stimulus money runs out.


“The planning going into that rail system will go on for years,” she said.


Solis received a respite when she fielded questions from the other side of the aisle, where she was credited with returning the Labor Department to what Democrats see as its core mission.


“Instead of looking the other way, this administration is holding reckless employers accountable for putting their workers in danger,” said Rep. George Miller, D-California and chairman of the House labor committee. “The new department has also made strides to protect families’ paychecks from unscrupulous employers.”


Rep. Lynn Woolsey, D-California, praised Solis’ department for slapping the largest Occupational Safety and Health Administration fine in history—$87 million—on oil refiner BP for an explosion at a Texas facility in 2005 that killed 15 people.


“We are taking our job very seriously,” Solis said. “It does send a message to the industry overall.”


When it comes to policing its allies, however, the Labor Department is not so rigorous, according to Rep. John Kline, R-Minnesota. He asserted that the agency is reducing support for the division that keeps an eye on unions.


“I hope some of those troops on the ground go into the Office of Labor-Management Standards,” Kline said. He accused the administration of fostering a “culture of union favoritism.”


Solis said that she is trying to make the office “leaner, maybe a little more efficient,” without reducing union oversight.


Solis assured Kline that the department would “root out” union fraud and embezzlement.


Solis told reporters after the hearing that it will take time for the department to revamp enforcement.


“Our resources are very limited,” she said. “We’ve lost a lot of valuable time and staffing in the last decade.”


—Mark Schoeff Jr.


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10 Ways to Make Work More Meaningful

We may be entering the age of less meaningful work. Consider the following: Job satisfaction levels have been slipping since the 1970s. Social thinkers say the same thing has been happening with the work ethic. Work attitudes have also worsened over the years, with fewer people agreeing to the statement “Work is a person’s most important activity.”

Behind these attitudes are tumultuous years in the workplace. The last few decades have seen organizations go through more frequent, rapid and radical changes. Jobs are more intense and insecure. Three-quarters of Americans cite money and work as the leading causes of their stress. Yet, real income remains flat.

This alone is enough to make people cynical. Now throw in a few corporate scandals and such global threats as terrorism and climate change and people start asking serious, existential questions of themselves. Who am I? Why am I here? What should I be doing with my life?

The meaning of life is a hot topic. Eckhart Tolle’s A New Earth is a best-seller. Business blogs and magazines are buzzing about meaningful work. Author Malcolm Gladwell called for more of it in his book Outliers. Even the hard-nosed consulting firm McKinsey & Co. is extolling the virtues of touchy-feely rewards in place of pay and bonuses. It makes sense that people are demanding more meaning in the workplace, since they spend most of their waking hours there.

I first stumbled upon the importance of meaningful work in my Ph.D. data. I called it the “Sisyphus Effect,” after the mythical figure who was cursed to roll a large boulder up a hill, only to have it roll back down again, repeatedly, for all eternity. His curse is the embodiment of meaningless work—no variety, control, feedback, recognition or significant impact on anything greater than himself. These are the five “must haves” of meaningful work, and they played a part in every outcome I measured, including depression, burnout, satisfaction, commitment and the desire to leave a job.

All of this got me wondering. How important is meaningful work? And is it getting harder to find?

I surveyed 1,400 Americans on nearly 300 job characteristics over five surveys. The following characteristics were among the top 25 strongest drivers of commitment and intentions to stay that were also reported at lower levels in organizations. What was scarce among the strongest drivers of commitment and intentions to stay was a job that:

• Helps you to fulfill a life purpose.

• Helps you to become what you were “meant to be” in life.

• Is a major source of life happiness (e.g., makes you feel “alive”).

• Involves tasks that you would do for pleasure on your own time.

• Enables you to do good things in the world.

The message here is that there is room to improve these aspects of every job, in every organization. These changes could pay off in higher commitment and retention. It’s not younger or older workers who feel this way. There were few generational differences, which suggests that these things are equally important to all generations.

You may also think that these things are unimportant in a bad economy, when people’s jobs are at stake. Yet, these surveys were conducted during a period of the last recession which saw some of the deepest dives in employment, GDP and the S&P 500.

I’m not predicting a mass exodus of people cashing out to volunteer for Doctors Without Borders. But if recent work trends continue, we could reach a tipping point. More people are having an existential crisis of confidence about their jobs, and perhaps, the nature of work in their lives. They call this transcendence in existential circles. Zen Buddhists call it a “satori.” And it’s irreversible.

Once you lose employees’ hearts because they don’t feel that what’s deeply meaningful to them (as human beings, not as employees) is present during the workday, you may lose them for good. And if they stay, they could still withdraw psychologically and reapply their extra energy elsewhere. In other words, they’ll do the minimum that’s expected of them and go home to what really matters.

All is not lost, however. Organizations can bring more meaning to every job. There are easy ways and hard ways of doing this. Here are 10 easy ones:

1. Measure meaningful work on your next employee survey. Make sure your survey taps the workplace features mentioned above: a job that helps fulfill a life purpose, a job that helps people be what they are meant to be, etc.

2. Find out what really matters to employees. Try asking this on your next employee survey: “If you woke up tomorrow morning with $20 million in the bank and five years to live, what things would you do for the rest of your life?” Now, find “low-cal” ways of making work in your organization seem more like these things.

3. Communicate meaningful work that’s already there. Meaning is partly a state of mind. Employees may already have opportunities for meaningful work that are not well communicated. Make the connection between individual jobs and the purpose of the organization.

4. Connect employees with people who have been changed by your organization. Invite people to give testimonials at annual meetings and town halls. Start a “twinning” program among employees and clients. Collect and share client stories or videos.

5. Ask your employees how they can have a bigger impact. Conduct surveys and focus groups. Get ideas and empower employees to implement them.

6. Enable employees to do philanthropic work outside of work. Donate the time and money, set up a program and offer a suite of opportunities.

7. Offer career counseling “plus.” Not all development is career-related. People are human beings before they come to work. Consider what they’re trying to accomplish in their nonwork lives and who they’re trying to become. Support those efforts.

8. Coach managers to provide better feedback and recognition. These are two “must haves” of meaningful work that I’ve identified in my other research, and they’re relatively free. This could be done tomorrow. Recognition is important for employees to see their impact.

9. Use meaningful work to attract and recruit people. If you’ve got meaningful work in your organization, flaunt it. Review your current strategies for acquiring talent and make sure the message is there.

10. Make a pledge about job and organizational redesign. This is a longer-term goal, but get it on the radar. Revisit job descriptions and reporting lines. Get employees to brainstorm how they could do their jobs differently. This is at the heart of “job crafting,” a technique from Amy Wrzesniewski at the Yale School of Management. Don’t assume that meaning is inherent only in certain jobs. Most of them can be imbued with more meaningful features.

Workforce Management Online, February 2010 — Register Now!

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The Blind Side of Motivation A Short Lesson in Perception

During lunch on a recent business trip, four men were seated at a nearby table.


Immediately, one man emerged as the obvious supervisor of the group. How could I tell? He did all the talking. The others did all the listening.


The supervisor started in before the water was even brought to the table. He leaned forward, arms crossed in front of him, and began to talk at the others. His brow was furrowed and his voice crisp and commanding as he peered over the top of his glasses at them. Everything about him shouted that he was in charge.


When someone finally did venture out and pose a question, the supervisor just raised his voice and talked right over the top of him. He said, “Well, that is not going to happen!”


While I wasn’t close enough to hear the entire content of the conversation, here are some of the snippets I jotted down on my napkin:


“ … it’s not gonna fly!”


“ … never tell anyone … ”


“ … we’re all in this together … reflects on all of us.”


“ We’ve had them for 20 years … ”


“ Don’t get on board and then criticize …”


“This is a lot harder than you think!”


“If you don’t remember anything else from today, remember this …”


At first, I thought this was to be a casual team lunch. But I soon realized that the other three men had been invited so the supervisor could coach and counsel them about some recent issue. However, it quickly became apparent to me that this supervisor was not getting the results he desired.


The men sat back in their chairs, crossing their arms over their chests. With their heads slightly down, they watched the supervisor through cautious and guarded eyes.


It began to dawn on me that there is a huge difference between our intentions and how others interpret our actions.


After pondering this event, I think there are three lessons to be learned.


First, this supervisor’s intent was to correct and motivate his staff. Yet he seemed unaware of how he was coming across and seemed blind to their reactions. Had he been watching their body language, he’d have noticed them leaning back and disengaging.


So the lesson is, if we acknowledge we have a blind side, we’ll be more attentive to how others react to us—and modify our communication style as needed.


Second, the supervisor probably believed he was doing a good job by executing his duties with authority. Unfortunately, his team’s body language told another story. He was being perceived as a ranting tyrant, especially when he pointed and gestured with his hands to make his point.


The lesson is, we are not always perceived the way we see ourselves. Again, tuning in to the nonverbal communication signals of others can help us be more successful in getting our points across.


Third, the supervisor’s intention was to coach and change the behavior of his team. The way it was interpreted, however, was that he was being critical, overbearing and dictatorial.


No one spoke. No one dared ask for clarification. Everyone looked defensive and bewildered.


My guess is that when they went back to the office, nothing changed (except that the staff made a wider swath around the supervisor whenever they saw him coming). So the lesson is, we should try to imagine what it would be like to be listening to us!


Then, if we think more about the end result we want (before we engage the tongue), we will take a more effective approach. As a result, we will enjoy a harder-working and higher-achieving workforce.


How do we get insight into how we’re being perceived? Become the master of asking questions. Listen more, talk less.


Ask how others see the situation. Learn to build trust. I’m quite confident that if this supervisor had approached his team by asking for their input and ideas, he would have had much better results.


Our goal should always be to bring out the best in others. We can accomplish that by making our team feel like their input is valuable—that they are part of the solution, not part of the problem.