NO MORE BS: Bait and Switch “Customer Relations”

As I begin, there is a need to stress that everything done by the company is perfectly legal, not moral, not ethical, and not appropriate to long-term customer relations, merely legal.  I stress this because the company involved has continued to fall back on their legal disclaimers as the perfectly acceptable method for committing fraud, theft, and calling this “customer relations.”  As we are naming names, the offer continues to stand to print the company response if they ever grow up and address me as an equal, and not a child to be scolded by a boilerplate contract.

Blogging Bait and Switch Moves: A Misleading Blog Title Sucks | BrainzoomingOn 10 May 2021, I was informed that my financing was finally clear, and I was set to close on a home on 14 May 2021.  On 11 May 2021, while conducting a search online, I came across an advertisement for Alliance Van Lines Inc. from Palm Beach Florida.  The company offered a reasonable rate to move my household goods from Phoenix, AZ., to Las Cruces, NM., and I paid a deposit.  The verbal agreement was, “We have a driver in Northern AZ., he has to come through Phoenix on Saturday and can deliver in Las Cruces Sunday, as he heads to his final destination for a Monday delivery.”  The phone representative went so far as to place me on hold, and “check” with dispatch for space availability and to double check times for picking up my household goods (15 May 2021) and delivering them (16 May 2021), without hindering his driver’s final destination.

I paid the deposit.  Assured by the representative that my deposit was refundable, and everything was planned.  I would get a call 24-hours before the driver arrived to confirm pick up times.  I got a call, within 10-minutes of the Palm Beach office closing to confirm my household goods would be picked up, delivered to Las Vegas, Nevada, and then available for delivery sometime in the following 7-10 business days in Las Cruces, New Mexico.  This was not the agreement and expectation as set on the 11th of May.  I called Alliance Van Lines Inc., the representative hung up on me, and when I called back, the phones had been set to night voicemail.

Bait & Switch — SteemitMonday, 17 May 2021, I get more than 20-calls and finally an email claiming that my signatures and the name on my credit cards do not match and to call to rectify this oversight as soon as possible.  Since the 17th of May, I have sent emails asking for my deposit back to no avail.  No explanation as to why the deal changed, simply the reliance upon a boilerplate contract agreement, and the firm insistence that I was in the wrong in what I heard and my expectations of what was happening.  If, Alliance Van Lines Inc., responds to this article, I will be glad to post their reply as a follow-up.

Bait and Switch

From the Legal Information Institute at Cornell Law School, we find the following definition of the legal term, bait and switch.

A “bait and switch” takes place when a seller creates an appealing but ingenuine offer to sell a product or service, which the seller does not actually intend to sell. This initial advertised offer is “the bait.” Then the seller switches customers from buying the advertised product or service that the seller initially offered into buying a different product or service that is usually at a higher price or has some other advantageous effect to the advertiser. This is the “switch.” Normally, the switched product that the consumer buys is usually at a higher purchase price, an increased profit for the seller, or may have a less marketable characteristic than the product advertised.”

There are four legal criteria for a bait and switch:

“… The key components for evaluating a claim of improper bait-and-switch” by the recipient of a contract are whether:

(1) the seller represented in its initial proposal that they would rely on certain specified employees/staff when performing the services;
(2) the recipient relied on this representation of information when evaluating the proposal;
(3) it was foreseeable and probable that the employees/staff named in the initial proposal would not be available to implement the contract work;
(4) employees/staff other than those listed in the initial proposal instead were or would be performing the services.”

Bait & SwitchJoe, the employee who called me, represented in the initial proposal that his driver was available with the needed deck space to haul my load of household goods on 15 May, deliver on 16 May, and continue on his way to his final destination, and that my load of household goods was a perfect fit to finish out his load from Northern AZ; thus, the first criterion of a legal bait and switch was met.

I, the customer and recipient, relied upon the verbal disclosures from Joe to make a plan for moving my household goods.  Thus, criterion two was met.  However, I did not know that the pickup was going to be done with a 26’ truck at the time of Joe’s call and my putting a deposit down.  Nor was there ever any discussion about a third party handling my stuff, moving it to Las Vegas, Nevada, and then delivering the goods in the next 7-10 business days.  Nor, was I offered the more expensive method of direct delivery, which the representative contracted by Alliance Van Lines Inc. was willing to sell me for direct delivery to Las Cruces.  Hence criterion three and four have been met.  A legal bait and switch occurred, and I have lost the deposit of $698.00, a not insubstantial amount of money at this time.

As soon as I knew I had been baited and switched, I sent the BBB in West Palm Beach a customer complaint.  I had to dig deep financially to meet the moving expenses in a hurry, and then had to drive a truck for 6-hours to my destination.  While help was available to load and unload, the plan was blown, my health during the trip was not good, and my wife suffered greatly while riding in the truck.  I mention these facts because it was not a small feat to arrange loaders and unloaders, rent a truck and car carrier, and move, all at the last possible moment on a Friday and Saturday.

Knowledge Check!As an interesting counterpoint, I met two great people in Phoenix, who worked for Vet-Ops, who loaded our truck, at the last minute.  I highly recommend these guys as they were smart, agile, flexible, and performed marvelously the loading job.  We also met two great unloaders from Move Doctors, and wish to thank them for their incredible speed, professionalism, and enthusiasm for unloading our truck and fitting our needs into their hectic schedule at the last minute.  If we ever have need of these gentlemen again, I plan to look them up.  U-Haul deserves mention as they were able to, at the last possible moment, arrange for a truck and car carrier.  U-Haul was very accommodating both in Phoenix, and in Las Cruces and deserve the highest praise for their professionalism and support of our move.  The three companies who picked up Alliance Van Lines Inc. slack were the epitome of providing goods and services at the price quoted, in a timely fashion, and in a manner that embody a desire for growing customer relations.

Bait & Switch 2Alliance Van Lines Inc. you have brought shame upon yourself and I wish you the best with the consequences!  A bait and switch are never allowed, never acceptable, and always unethical and immoral.  May you be happy with your choices and their inherent consequences!

© 2021 M. Dave Salisbury
All Rights Reserved
The images used herein were obtained in the public domain; this author holds no copyright to the images displayed.

NO MORE BS: QT and LHI – Let’s Talk Customer Service

Thank you!For a long time, I have deeply respected QuickTrip (QT).  Their customer service is of such outstanding quality; even when their fuel is more expensive, I still prefer shopping at QT.  The people go out of their way to help you have a fantastic customer experience.  I have never had a rude employee, a poor customer interaction, or left with an unresolved problem.  I struggle with a cane and neurological issues and have had doors held open for me; cashiers have brought me my change, always a good experience at QT.  Thank you!

On the other end of the spectrum, you have the Department of Motor Vehicles, and they are joined by Logistics Health Incorporated (LHI).  I have had my share of detestable customer service experiences; I am a customer service subject matter expert and have been regularly published on customer service topics.  When I rate LHI as competing for the DMV for the worst possible customer service provider, LHI might even have the DMV shaded!Angry Wet Chicken

16 April 2021 – I enter LHI at 5333 N 7th St, Phoenix location; I am 35-minutes early to a 1200 appointment.  On 25 March 2021, the Gov. of Arizona stopped enforcing mandatory masking.  As a person with a documented medical condition where I struggle to breathe enough volume per breath and cannot physically wear a mask, I did not wear a mask to this appointment.  I was rudely asked to wear a mask by the receptionist.  I showed her my Dr.’s note about having breathing problems where I cannot wear a mask.  The receptionist, after making considerable noise, canceled my appointment as a no-show.  Guess who is not going to be paid for my mileage to and from the facility.

I went to my car, called LHI Customer Service number 866-933-8387; the representative tried calling the facility.  After several hold sessions, she told me she would find me a provider who would work with me on the mask issue to complete the VA Contracted Compensation and Pension Appointment.  I never heard back from this representative.

Angry Wet Chicken 27-10 days later, I receive a call to reschedule an appointment spending more than 2 hours talking to the representative, who finally schedules me an appointment with another non-LHI provider in Phoenix for 10 May 2021.  I received a call from that provider confirming I have an appointment.  Yet, a bait and switch occurred, and my appointment was then rescheduled for the same provider, same LHI facility, and I attended this appointment.

0750, 10 May 2021 – I arrive early for the 0800 appointments.  The receptionist is belligerent when I walk through the door about me not being seen without a mask.  She further stipulated that since I can talk, I can wear a mask, and nothing I say will change that “medical opinion.”  She eventually tells me to call customer service and have them call her to relate treatment instructions.  She refused me a supervisor and then proceeded to make a bunch of calls, often holding her iPhone in one hand and the office phone in another.

While on the phone with Emily at LHI, at 33:35, into my call with the LHI customer service center, the Phoenix Police arrive.  The receptionist had called 911 and claimed, “I have a disruptive patient, who refuses to follow directions, is swearing, and throwing things, and refuses to leave the building.”  Officer Pacheco Badge #11039, Report # 21-725905, and his partner arrive, speak with the receptionist, who repeats her claim, then they talk to me.Apathy

I report I have not used swear words.  I have not thrown anything.  I have not been told to vacate the premises.  I have a medical condition that precludes me from wearing a mask, and I cannot physically wear a mask.  I show the officers my Dr.’s note to this effect.  The officer then turns to another patient who happened to have come in after me, and he confirms to the officer everything I said.  The worst language that the receptionist can truthfully claim that was used at her was “belligerent” and “snowflake.”  I will own the fact I called her belligerent and a snowflake.

Angry Grizzly BearThe officers go back to the receptionist, who two other people have now joined, names unknown, wearing scrubs presumably from the treatment rooms in the back.  They then make several calls.  Then one of the people asks if I can wear a mask but not over my nose.  I explain it is a breathing volume problem I have, and any mask hinders my volume of air per breath and makes breathing difficult.  The people behind the desk are seriously unhappy that my breathing problem does not have a name, a disease, or some identifying characteristic: the receptionist, the officers, and the people from the back return to a hushed conversation.  I am still on the phone with Emily and on hold while Emily is trying to contact the site.quote-mans-inhumanity

Finally, a decision is made, would I wear a face shield.  I claimed I have offered to wear a face shield twice and been told, face mask or nothing by the receptionist.  A nurse practitioner finally agrees if I wear a face shield, she will see me.  She then spent the next two hours complaining about me being an hour late to the appointment, her “very full schedule,” and how we had to “get this done quickly.”

Then, the nurse practitioner proceeds to lecture me twice about getting the vaccination for COVID-19 and how if I had the vaccination, they would be more comfortable with me not wearing a mask.  At no time, in the first or second interactions with the receptionist, did anyone ask me if I had received the vaccination.  I then finally left with a lecture about not being “anti-vax.” How she had no symptoms or post-injection problems, and how since I already have breathing problems, my comorbidity meant I should be seriously considering getting the vaccine.VA 3

I am not “Anti-Vax!”  I want my questions answered before I get the vaccine.  I want truthful information from peer-reviewed resources that I can reference and discuss with my primary care provider, neurologist, podiatrist, and other specialists who help me manage my health.  I want to know about drug interactions and the vaccine.  I need to know how this will affect diabetes because the experiences of Indians who are diabetic have been horrible!

I have no idea if the nurse practitioner did her job or just wasted my time.  What I do know is that LHI is about 100% useless in their customer service!  Failure to keep promises is the number one reason why trust is built or shattered.  Failure to carry through with what you promise is the second most common reason why trust is Bird of Preydestroyed in customer service.  Face-to-face providers need to be looking for solutions, not actively looking to inconvenience the customer.  100% of the medical profession IS customer service.  How the provider approaches the customer (patient) is the number one factor in how that patient will respond to treatment.

LHI, if you decide to respond, I will indeed include your response in a follow-on article.  However, at this moment, you have scored with the DMV as the worst possible example of customer service, and I hope you learn fast to care for the patient better!  I am fed up with your treatment, and change is mandatory; immediately!

© 2021 M. Dave Salisbury
All Rights Reserved
The images used herein were obtained in the public domain; this author holds no copyright to the images displayed.

NO MORE BS: Government Customer Service

Duty 3As a subject matter expert on customer service, as a professional customer service provider, and as a concerned American, I have to state for the record, the government’s abuse of the taxpaying customer is beyond atrocious, ridiculous, and craven!  I am sick to death of being treated like cat vomit; when I seek customer support from the government, I pay such incredible sums to fund.  Worse, I am fed up with the bureaucratic mindset that places the customer in the wrong, the customer as a pain, and the customer as a nuisance to be endured instead of assisted professionally.

ProblemsMy local Post Office here in Phoenix was visited yesterday (03 March 2021).  The Post Office does not deliver packages to the apartment complex we live in, so the standard procedure is for the USPS delivery person (mailman) to place a card notifying the customer of a package on a 10-day hold in the customer’s mailbox.  Since we moved in, we have not gotten these indicators, and Monday, my wife was notified a package she needs was returned by USPS.  It was delivered Monday to the Post Office and returned to sender as “customer refused delivery” the same day.

I went to the Post Office seeking answers.  The counter-working postal representative was the epitome of rude, obnoxious, and downright unfriendly.  It took more than an hour for a supervisor to arrive, and upon discussing the problem, I was told, “Lots of your neighbors have been complaining about this issue.”  Are you kidding me?!?!?!  You have two 500+ Apartment complexes across the street from each other, multiple people from both complexes are complaining about package delivery failures, and with a smile, you can tell me this is a known issue.

Theres moreAsk yourself the following question, if you had upwards of 100 customers complaining about your work, how long would you remain employed?  Frankly, I am still stunned 24+ hours after the interaction with this supervisor.  My visit was the sixth time I had been to the Post Office complaining about not getting package notifications and having trouble with packages sitting around the post office taking up space.  One of these visits included speaking to the Post Office’s head, general, whatever, the top person in charge of a local post office is titled.  Still, the employee has maintained their job, kept the same route, and the customers continue to be abused.

After I wrote a formal complaint, I was assured that action would be taken, and the employee talked to about this oversight in their duties.  Seriously, that was exactly what the supervisor said, “the employee will be talked to.”  I understand the human resources processes, understand and have designed human resource processes, and possess a Doctor of Psychology title specializing in industrial and organizational psychology.  But, I do not know how 100+ complaints can arrive at the post office weekly, and the same mailman is only on their verbal reprimand for failure to perform their duties.  We have been complaining about this issue for a year now, and in speaking with several neighbors, they have been complaining for longer than a year about this failure.  I have some doubts that this issue will be resolved, ever!

Detective 4But hey, the Post Office is only one of the government agencies exhibiting a race to the bottom where customer abuse and customer disservice are concerned.  The Department of Motor Vehicles (DMV), a state-run agency, is always in this race, and they take hostile customer service to new heights, or depths, depending upon how you look at their performance.  The last visit to the DMV ended with screaming for several minutes in my car before possessing the proper mindset to drive away safely.  The DMV is comparable to a dentist drilling before anesthesia starts and doing a poor job on an infected tooth; you just know you will have a bad day when a visit to the DMV is scheduled!

Yet, in discussing the race to the bottom, the Department of Veterans Affairs (VA) is also a constant competitor in asinine customer service practices, customer abuse, and inept inertia.  I do not think the VA could even get bureaucratic inertia correct if someone had not taught them how.  The Department of Veterans Affairs – Office of Inspector General (VA-OIG) investigated a surgical supply program for abuses and found:

VA controls were not sufficient to ensure VA medical facility staff accurately reviewed, verified, or certified distribution fee invoices for the program. VA also did not ensure staff at medical facilities accurately established and applied the on-site representative rates and paid fees based on annual facility purchases. The pricing schedule establishes fee rates for on-site representatives based on annual facility purchase amounts.”

The amount of money involved is staggering ($4.6 Billion). The fact that the VA cannot correctly oversee a supply program, check invoices, monitor stock levels, and pay invoices properly does not bode well for integrity in customer service.

LinkedIn VA ImageThe VA is to be congratulated, the colonoscope, which is used on multiple patients for a colonoscopy, is being cleaned properly and to standard, which means that infections from one patient are less likely to occur in another patient transferred from the colonoscope.  However, the training program, certification program, and training documentation remain under considerable scrutiny for continual failure, as discovered by a VA-OIG investigation of 10 different clinics!  Training, certification of training, and documenting and tracking training are internal customer service actions that the entire VA continues to fail.  Whoever is in charge of adult education and training at the VA is not performing their jobs, and this is witnessed every couple of weeks in the VA-OIG investigation results across the entire VA.  Designed incompetence leading to customer service failures, absolutely ridiculous!

I-CareThe VA-OIG conducted a lengthy investigation at the Veterans Benefits Administration (VBA) Chicago VA Regional Benefits office in Illinois.

The OIG found claims processors did not properly correct administrative errors in 88 percent of cases reviewed. Errors resulted in improper underpayments of about $59,100 to six veterans, improper overpayments of $18,900 to two veterans, and $5,900 in debts VA had inappropriately collected from eight veterans through January 2020.”

Revisiting the Post Office example above, if you had an 88% error rate in your job, how long would you expect to keep your job?  Training and certification of claims processing personnel remains a failure of internal customer service and is mentioned in every VBA investigation by the VA-OIG.  As a point of fact, the failures of training and training certification were recently cited as a significant deficiency, where in 2018, no certification and training occurred due to internal technical problems with the intranet.  Yet, even with all this evidence that training is failing, certification is not occurring, and claims processors continue to abuse veterans through clerical, system, procedural, and process errors on claims, they maintain their positions.  Cited in this latest VBA investigation was the claims processors’ continual failure to communicate with the veteran.

Boris & NatashaConsider the following analogy.  A 100% disabled veteran gets paid once a month and budgets those monies very carefully to last the entire month.  A claims decision is made, and without any communication for why, the amount the veteran is expecting to live is cut in half.  The veteran is then responsible for wading through the various call centers to find why, how the decisions were made, and what to do, which takes time, lots, and lots of time on the phone.  While bills go unpaid, food goes unpurchased, financial difficulties mount, and correcting the situation takes more time.  Sure, the VA will pay back pay, but that is never sufficient to cover all the accruing costs and losses experienced.

Hostile customer service by the government is the most inexcusable example of customer disservice imaginable.  Why; because there is no competitor to move your business.  There are no pathways for holding customer service representatives accountable when even talking to a supervisor is not worth the time and effort.  I spent four hours on the phone chasing a claims processing error; at one point, I finally got so mad I demanded a supervisor.  I waited on hold for just under 120-minutes for the supervisor, who said had I worked better with the agent, I would not have had to wait, and the problem could have been resolved, as their opening statement!

Survived the VABy this time, I had worked with four separate agents who were confused or refused the call by hanging up.  I had been sworn at, I had been told I was a liar, and I was told my office could not handle your request.  Each call required anywhere between 30 and 50 minutes of hold time waiting for an agent.  As the supervisor reviewed the problem, they discovered that their agents could not have handled the situation, and a specialist was required.  But, I never got an apology from the supervisor for the waste of my time, the issues experienced with previous agents, nor the loss of my time and resources it took to handle the problem.

Gadsden FlagGovernment employees beware; how you treat customers is a problem, and you need to be held to task for your insolence, depravity, ineptitude, inertia, and uncaring attitudes!  When discussing the BS of government, the customer service issue is the most egregious.  I will call you out publicly every time you abuse a customer.  I am done being abused!

© 2021 M. Dave Salisbury
All Rights Reserved
The images used herein were obtained in the public domain; this author holds no copyright to the images displayed.

Where is the Patient Advocate? – A Story in 3-Emails

Three secure messages, sent through the My Health eVet secure messaging system, all related to a need for VA Hospital services, and all reflecting something in common, the VA’s refusal to act.

First Email: Good Morning,

I have but one question, I would appreciate a timely and thorough response, within 24-hours. “Where is the advocacy from the patient advocates?”

Last Wednesday I needed to discuss the problems I am having with pharmacy refills, but was bounced off VA property because I can NOT Physically. Wear. A. mask! This is for patient safety concerns. Why am I being discriminated against and refused care at the VA Hospital and the patient advocates office is doing nothing to help improve this situation?

I was promised a letter from the VA Hospital Director over the incidents from June and July, still no response from the director or advocacy from the patient advocates. Why?

I need to be able to access the VA Hospitals services and cannot do so when the VA Police are enforcing a mask policy that puts my life in jeopardy! Without an adequate workaround to the mask policy, I suffer from refills that are delayed, and without the drive thru pharmacy, now have no recourse to develop a solution!

Why? Where are the Patient Advocates in standing up against the bureaucracy and demanding solutions for patient problems? Where are the Patient Advocates regarding the incidents from June and July, using hard evidence to improve VA Hospital performance?

Enough is enough! Where do I find a patient advocate?

Thank you!
Dr. Dave Salisbury

Second Email: Hello,

Is there a reason the drive-thru pharmacy is no longer?  I must get refills and the refill process through the mail is taking 3-5 times longer than normal; thus, reordering when you have a 10-day supply remaining is not good advice as I keep running out before the delivery is made.   Only because of the drive-thru pharmacy have I been able to stay ahead of medication emergencies with the refill process being broken.

Why? How do I get refills; when, because I cannot physically wear a mask, I cannot be seen in the VA ER or walk into the VA Pharmacy for refills?

I am thoroughly and completely out of two medications, they have both been reordered and I have no word on when they will arrive. The last refill on a diabetic medication took longer than normal (7-10 business days) to be received and I wonder when I should schedule reordering that medication with the added slowdowns and longer delivery times.

How do I gain refills when I have zero access to the VA Hospital and the refill process has failed to delivery on time?

Thank You!
Dave Salisbury

Third Email: Dr.

I do not know what is happening with pharmacy, but something must give! I reordered my refills with plenty of time since March 2020 through the Phoenix, VAMC, and I keep running out before the meds arrive!

Due to the continued increased symptoms, usage of medication increased, but the refill process has slowed, and without the drive-thru pharmacy I am stuck without access to pharmacy.  Especially, since I can never get a straight answer when trying to use the phone.

As of this morning, I had to wake up, and take the remaining dosage and two Advil for the crushing, horrible light sensitivity, facial pain, twitch bordering, headache! How do I get this refilled with the drive thru pharmacy out of operation, and the VA Hospital off limits because I cannot physically wear a mask?

I have, as if this writing 0330 27 October 2020, been out of one medication for two days, having taken the last pill on Sunday (25 October 2020)! One of the reasons why I had 90-day supplies, instead of the VA (policy?) 30-day supply in Albuquerque was because of this exact reason, I kept running out before the deliveries were made. I must be able to trust the VA Pharmacy Refill process, and the pharmacy refill process is untrustworthy, and currently in disarray.

I showed up at the hospital last week (21 October 2020) trying to have this conversation with pharmacy and was first kicked out of the hospital, then escorted off property because I cannot safely wear a mask and asked why.  I also asked for a copy of the mask policy, and had a supervisor turn himself into a pretzel trying to explain why he cannot produce a policy upon request. What do I do?

Thank you!
Dave Salisbury

Before leaving Albuquerque, NM., I had the privilege of being able to discuss certain topics with local hospital representatives.  I had the ability to talk to directors, medical department heads, patient advocates, and so many more dedicated healthcare professionals who work in in non-VA or government run hospitals.  Every one of them stated categorically that if their hospital was run like the VA Hospital system, they would have been fired, and more than likely legally charged with malpractice, shut down, and sued.

Let that sink in for a moment.  The VA Hospital purports to be doing a service for veterans, but the biggest problem in veterans receiving care is too often the VA Hospital system, and if a non-VA Hospital was run in a similar manner, criminal, legal, and other repercussions would sink that hospital system forcing the government to take over to “rectify the situation.”  Yet, this atrocious behavior is tolerated where the veteran’s hospital system is concerned; I can only ask why?

“The VA Hospital purports to be doing a service for veterans, but the biggest problem in veterans receiving care is too often the VA Hospital system!”

Why is it that every time a solution begins to show the promise of working, the VA bureaucracy stifles the momentum, destroys the people involved, and the veterans keep suffering?  A recent VA Advertisement on LinkedIn talked about how the VA is available with a ready hand to help, it was very well marketed, the advertisement was full of great phrases, sound bite captions, and solemnity; except too often the marketing hype does not reflect reality. Yet, the veteran, the spouse, and the dependents suffer!

Want reality in a VA Hospital, if you and your symptoms do not meet a predetermined checklist of boxes, you are considered the problem and the VA Hospital cannot/will not help you.  The VA Physician cannot issue a diagnosis, nor can the records of patient interactions have sway with the Veterans Benefits Administration for a claim determination.  America sends troops all over the world, places them in literally thousands of crazy environments, but the Department of Veterans Administration still demands cookbook medicine, checklists, and cookie-cutter one-size-fits-most medical practices.

Want reality in a VA Hospital, ask a bureaucrat behind a desk why the patient is being inconvenienced, and watch how fast that veteran is labeled as “The Problem,” and the veteran gets surrounded by the VA Police who then threaten, attempt to intimidate, and arrest/fine that veteran.  Average current time is less than 2-minutes!

Want reality in a VA Hospital, look at the lack of cleanliness, everywhere, and monitor how long spills, blood on walls, black “gunk” stuck in corners, etc. stays around.  I have personally witnessed blood spots lasting on doors and walls for months before being removed, even after complaining about the mess multiple times.  One incident, on an ER treatment room door, there was a roughly 2″ blood spot, dried, sticking to the back of the door, was there for 18-months before finally being removed. Yet, the VA Hospital system will always cheer, about cleanliness, friendliness, and helpfulness of VA Staffing.

Want reality in a VA Hospital, depending upon the tier upon service conclusion originally assigned to, you will experience a significantly different VA Hospital experience.  Even if the Veterans Benefits Administration changes your disability rating, you do not change treatment tiers, and receive reduced medical care accordingly.

Need hospital records, run the leviathan and draconian process of filing a Freedom of Information Act (FOIA) request, and wait.  Need to understand policies and procedures, there is a FOIA for that as well, but do not expect anything written down; because, the VA operates upon the philosophy that if it is written down, then you can be punished for not complying.  Not having operational procedures, patient care processes, standards of behavior, etc. written down provides a ready-made excuse for when the VA Office of Inspector General (VA-OIG) calls investigating.  In over 10-years of reading and commenting upon VA-OIG reports, this remains the number one excuse for failures to comply, dead veterans, and incompetence masquerading around as leadership.

Where is the media, the watchdog of society?  Where are the elected officials whose job it is to monitor the actions of the bureaucrats to ensure these problems do not begin, let alone thrive?  Where is the patient advocate’s whose job is to stand between the bureaucracy, and the patient, to aid the patient in completing tasks that the patient cannot do for themselves?  Where are the patient advocates who are supposed to be making suggestions for improvement based upon the data they collect from complaints and failures of hospital bureaucracy?  Where are the patient advocates in improving operational policies to protect the health and safety of patients, before that patient ever arrives at the hospital facility?

The VA has removed my access to the VA-OIG reports, it has been two-months since I saw a VA-OIG report in my email box.  This is standard practice for the VA, when problems arise, shoot the messenger instead of working to find and fix the problems, and this too is a reality at the VA!

© Copyright 2020 – M. Dave Salisbury

The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the pictures.

All rights reserved.  For copies, reprints, or sharing, please contact through LinkedIn:

https://www.linkedin.com/in/davesalisbury/

Call Center Chaos and Appreciative Inquiry

While this article discusses government call centers generally, and New Mexico (NM) Government call centers specifically, please do not think the problems described are specific only to, or lessons could not be applied to, many other call centers.  New Mexico Government call centers all have a common problem, they are purposefully designed to not help or serve the customer.  Worse, the work processes are convoluted to the point that work takes anywhere from 10 – 15% longer than it should, costing 30 – 50% more than it should.  Worse, if a customer gets connected to an “Escalation Department,” the workers in that department have no authority, no tools, and nothing they can do but repeat marketing materials, and hope the customer goes away.

Cute CalfEssentially, the NM Government call centers, at the city and state levels of government are as emasculated as a spring-born calf!  Let that sink in for a moment.  No tools, no authority, no support, and only their verbal wits to make the customer go away.  If you think this problem is only apparent in government call centers; well, you are wrong.

AT&T has a very similar, though not as endemic issue.  Sprint, the problem is both apparent and not considered a problem.  AIU, COX, Comcast/Xfinity, FEDEX, UPS, UoPX, and more, you all have very similar issues where the work processes and the customer service are disconnected, leaving employees emasculated and stuck spouting marketing lines in the hope of appeasing the customer.  Sure, some of you have better call escalation processes, but these escalation processes only show the emasculation of your people more exactly.

For example, take today’s interactions with a NM Government Call Center.  The representative on the call escalation line could very easily reach out to their supervisor and take the criticisms and ideas from the customer’s call, put them forth as their own ideas, and improve the call center and customer attentiveness of the organization.  Unfortunately, sad experience has shown that new ideas in NM Government Call Centers are anathema to the good order and discipline of the call center.  Thus, proving that the endemic lack of customer attentiveness is systematic in NM Government Call Centers and considered a benefit to the customer/taxpayer using the government service.

Purposeful customer abuse is not appreciated, not acceptable, and eventually leads the call center to ruin.  Which is a monumental waste of the potential in your employees, as well as being ruinously expensive for some future disaster.  In speaking with retail associates at Comcast/Xfinity and COX Communications, one learns from frontline representatives what to expect from calling the call centers.  If the retail associates are frustrated with the inability to be served, this is automatically passed to the customer.  Bank of America has this problem in spades!

Appreciative InquiryAppreciative inquiry is a growth mechanism that states that what a business organization needs, they already have enough of, provided they listen to their employees.  Appreciative inquiry and common sense tells leaders who want to know and change their organization, how, and where to go to begin.  Appreciative inquiry-based leadership is 6-continuous steps that start small, and cycle to larger problems as momentum for excellence permeates through an organization.  But the first step, just like in defeating a disabling addiction, is admitting there is a problem.

Coming back to the NM Government Call Center, the front-line supervisor upon hearing about this representative’s experience, chooses to believe there is a problem.  Knowing that the problems are endemic and systematic in the organization, decides, “For my team, we will be the core of excellence.”  Thus, this supervisor is now motivated to take the second step in the appreciative inquiry cycle, “Define.”

The supervisor defines what they can change, and then from that list of items that they can control will select the first item to change by asking themselves and their team, “Which item on this list can we tackle first?”  Thus, leading to the third step in appreciative inquiry, “Discover.”

Imperative at this step is the focus upon what is already going right on the topic selected.  Not focusing upon what is wrong, or upon what cannot be controlled or influenced by the team.  Focus on the positive, list the best of what is going right!  For example, if the inquiry will be reducing hold times, and the team has been trending down from multiple hours to single hours of hold time, focus on the positive, and get ideas about tips used from those who are successful in reducing hold times.

The idea in discovery is to create the motivation for the next step in appreciative inquiry, “Dream.”  But, do not dream small!  Remember, when you shoot for the sun and miss, you still land among the stars.  Dream BIG!  Dreaming is all about setting your sights on what currently is considered impossible, that your team can make possible.  Going back to reducing hold times, set the dream at 30-minutes.  You can always come back and dream bigger or repeat the appreciative inquiry cycle on this topic again in the future.

Next, “Design,” design the future and it becomes your destiny; which also happens to be the remaining two steps in the appreciative inquiry cycle.  President Thomas Monson is quoted as saying, “Decisions DO Determine Destiny” [emphasis in original].  If you decide the status quo is acceptable, that decision determines the destiny, and ruination will follow.  If you decide to pursue excellence, this decision will determine how successful you and your team can be.  Design the future you desire, state the goal, write it down, post the goal, speak positively about the goal, and build momentum through accomplishing small steps towards the goal.

Thus, the destiny is born into fruition and what today is impossible, is tomorrow’s reality.  Destiny in the appreciative inquiry cycle is defined as creating what the future will be.  Positive growth occurs through incremental steps and changes the destination.

A pilot friend of mine loves the story about a new pilot who is making their first cross-country flight with a more experienced pilot.  The young pilot is close to being able to solo, and the experienced pilot knows the route, the weather, and decides to let the young pilot fly solo for a few hours.  The new pilot gets bored holding a single course and wavers a little to the left, and a little to the right of the base course and does not think anything of the consequences.  Several hours go by and the experienced pilot returns to the flight deck to discover bad weather is moving in fast, the small lane cannot fly in the weather that is coming necessitating an unscheduled landing, and the plane is 400-miles off base course.  The young pilot said, I only moved a few degrees left and right, we cannot be that far off course.  Later the experienced pilot shows a track of the airplane on a map to the young pilot and reality sinks in, by a matter of a few degrees, over time, the plane got in trouble.

A few DegreesAppreciative inquiry is exactly like the plane, by having a destination, defined according to positive desires, through the process of discovery, dreaming of the possible future, while designing the future, the appreciative inquiry leader can make the small changes today that move the destination from ruination to success.

The first step is admitting there is a problem, and desire to fix that problem at all costs.  What are you passionate enough about to fix at all costs?  Whether you are a representative or a company director, the same question applies and the answer will determine your ultimate destiny.  The key is action at all costs.  The efforts, time, resources, etc. will be spent to achieve does not matter, the new destination does matter.

A call center supervisor friend of mine had three stellar and highly experienced employees on their team.  My friend also had some young talent with incredible potential.  Because the three stellar employees did not want to become supervisors, this effectively blocked the new employees from achieving potential.  My friend had to make a choice, lose the new potential, or reorganize the team.  My friend chooses to keep the experienced people, and shortly after this decision was made, two quit for other opportunities, the new potential quit because they longed for professional growth, my friend was promoted, and the new supervisor had no depth of experience left on the team.

Some would blame the new employees for quitting too soon, others would lay the blame on the supervisor for not developing the talent pool, others might express dismay at the senior talent leaving; honestly, they are all right, and all wrong!  My friend decided to hang the costs, and the decision was a tremendous learning experience.  Using appreciative inquiry will provide similar learning experiences, prepare, and commit, now to learn first and stay focused on the positive.

Appreciative inquiry can help; there are six operational steps:

  1. Admit there is a problem and commit to change.
  2. Define the problem.
  3. Discover the variables and stay focused on the positive.
  4. Dream BIG!
  5. Design the future and outline the steps to that future.
  6. Destiny, create the destination you desire.

Follow the instructions on a shampoo bottle, “Wash, Rinse, Repeat.”  The appreciative inquiry model can be scaled, can be repeated, can be implemented into small or large teams, and produce motivated members who then become the force to producing change.  Allow yourself and your team to learn, this takes time, but through a building motivation for excellence, time can be captured to perform.

© Copyright 2020 – M. Dave Salisbury

The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the pictures.

All rights reserved.  For copies, reprints, or sharing, please contact through LinkedIn:

https://www.linkedin.com/in/davesalisbury/

 

The Power of Tiger Teams – Shifting the VA Paradigms

I-CareA key aspect of Tiger Teams is their ability to stress test, beta test, and routinely check how operations are performing and recommend changes from the position of the customer.  Recently the Department of Veterans Affairs (VA) – Office of Inspector General (VA_OIG) investigated a critical piece of the Mission Act of 2018, the health information exchanges.  While the VA-OIG received useful and valuable information from the VA and the community provider side, the customer/patient side was not included. From experience, I can affirm this is broken!

Recently, a veteran needed emergency care and received that care through the community providers under the Mission Act of 2018.  The records from the community care provider never transferred to the VA, the billing has been a mess of letters and notifications, and the patient’s issues were never followed up with the VA provider until the patient called and made it an issue.  One of the main selling points for community providers was to share electronic health information easily with the VA, which included notifying the primary care providers when a patient was seen in the community.  This aspect remains a “pie-crust promise” as well as a frustrating issue for patients and VA providers alike.

Before the Mission Act of 2018, if the veteran patient was sent to a community provider, the patient transferred manually all records to and from the VA and the community provider.  Allowing for lost records, duplicated records, and a host of problems in bureaucracy.  One of the issues the veteran experienced in seeking community care was the historicity of medical records to reduce costs and not duplicate tests; however, the community provider was never able to obtain that historicity and the emergency room costs were greater for the VA.

Thus, the need to operationally check the system, processes, and patient experiences using Tiger Teams.  A Tiger Team is a group of experienced people who interact with the business as customers, who have been granted the authority to make changes and see those changes implemented.  These are a selected group who work from a central office and are dedicated to improving business performance.  While I applaud the progress made with conforming to the Mission Act of 2018, there remains significant work in the patient experience to be completed and currently, the situation is not the roses and rainbows the VA-OIG is portraying.

ProblemsTiger Teams are also helpful in another way, that of “bird-dogging,” or acting as the researchers, and developers of ideas towards making improvements.  The VA-OIG recently brought to light that the VA needs to expand retail pharmacy drug discounts.  With the number of prescriptions filled by the VA hourly, the fact that the VA does not have volume discounts was surprising, but unfortunately, not unexpected.  The VA-OIG estimated that of the $181 million spent on retail drugs in fiscal year (FY) 2018, $69 Million would have been saved.  From the VA-OIG report:

“VA is one of four federal agencies eligible by law to receive at least a 24 percent discount for prescription drugs purchased for its facilities and dispensed directly to patients. However, for prescription drugs purchased through retail pharmacies for beneficiaries, VA pays the higher average contracted wholesale price because it does not have the authority to require drug manufacturers to provide the drugs at discounted prices.”  [Emphasis Mine]

Unfortunately, the program inspected for savings on retail pharmacy prescription was but one of several VA drug programs lacking statutory authority to save the taxpayers from being gouged on prescription drugs dispensed through retail programs at the hands of the VA.  Hence, the findings are surprising, but not unexpected.  How long before the VA secretary will collaborate with the Office of Regulatory and Administrative Affairs to pursue whatever changes are required to give VA the appropriate legal authority to purchase all prescription drugs through retail pharmacies at discounted prices?  At the tune of one program saving $69 Million a year, the benefits add up in a hurry.

How would Tiger Teams help in this situation; by doing the legal leg work, establishing relationships, initiating inquiries, and discovering all the other programs where the statutory authority is missing to close a gap and save money.  While the VA Secretary is responsible, delegating this authority to a Tiger Team saves time and improves the patient and taxpayer experiences.  This is why the Tiger Team must work from the VA Secretary’s Office, endowed with the power of the secretary, to make and affect change for the good of VA.

Leadership CartoonFinally, the power of Tiger Teams is also manifested to the VA in another way, returning to a situation after the VA-OIG has made recommendations to ensure compliance occurs.  Another recent VA-OIG report shows that after a scathing VA-OIG inspection, the Department of Veterans Affairs – Veterans Benefits Administration (VBA), was still out of compliance in their internal quality control procedures, systems, and processes.  While some improvement had been made to spot errors, the procedures and processes that allowed those errors to occur were receiving zero attention by the internal quality inspectors.  Which is akin to noticing the horse is out of the barn, but not shutting and locking the door to keep the horse in the barn.  There is no valid excuse for the VBA quality controllers to not have been doing their jobs since the last VA-OIG Inspection.

The Tiger Team, with sufficient and specific authority, has the power to cut through the excuses, the red tape, and the intransigence of federal employees to root out the why, and establish a path to correction.  Yet, the VA Secretary is not using the Tiger Team concept as a tool to effect change, power compliance, and intervene to improve the veteran experience with the VA, the VBA, the VHA, and the National Cemetery.

Suggestions for improving the processes at the VA continue to include:

  1. Establish forthwith a roving Tiger Team, provide these employees with proper authority, and set them to work fixing the VA.  Allow the Tiger Team to establish flying squads inside the agency, hospital, medical center, etc. to report back on compliance issues, and any pushback they receive in correcting errors.
  2. Cut the bureaucracy that intransigent employees are using as a tool to stop or slow down change. The VA’s internal bureaucracy is the tail that wags the dog and since it is out of control, it requires an external force to regain control and proper order.
  3. Imbue the Tiger Team with an active mission statement, purpose, and organizational design. The Tiger Team is an active, not passive, tool that requires people dedicated to making change and seeing results.

VA SealNever has the axiom, “If it ain’t broke don’t fix it,” been less true.  The VA is broken and desperately needs fixing.  With the help of those dedicated VA Employees, the proper leadership, and a Tiger Team to aid, the VA can be fixed and fixed quickly!

© Copyright 2020 – M. Dave Salisbury

The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the pictures.

All rights reserved.  For copies, reprints, or sharing, please contact through LinkedIn:

https://www.linkedin.com/in/davesalisbury/

Customer Service Begins with Employees – Knowing the Paradigm

During the last 60 days, I have had the ability to see two different companies and their training programs up close and personal.  Both companies provide call center employees, and currently, both companies are employing a home shored or remote agent to conduct call center operations.  Neither company is handling remote agents very well; and, while both companies have excellent credentials for providing exterior customers with excellent customer service, both companies fail the first customer, the employee.

ProblemsCompany A thinks that games, contests, prizes, swag, and commissions adequately cover their inherent lack of customer service to employees.  Company B does not offer its employees any type of added compensation to its employees and treats their employees like cattle in a slaughterhouse yard.  Both companies talk an excellent game regarding treating their employees in a manner that promotes healthy exterior customer relations, but there is no substance, no action, no commitment to the employee.  Company B has an exceedingly high employee churn rate, and discounts that rate because of employees working from home and not being able to take the loneliness of an office atmosphere.  Company A has several large sites and is looking forward to having employees back on the call center campus.

When the conclusions for employee dissatisfaction were shared, the question was raised, “How does the leadership team know when the employees are not feeling served by their employer?”  The answer can be found in the same manner that the voice of the customer is found, mainly by asking the employees.  Neither company has an employee feedback process to capture the employee’s thoughts, ideas, feelings, and suggestions; relying solely upon the leadership team to provide these items.  Neither company overtly treats its employees poorly, Company A does have a mechanism to capture why employees leave the organization.  Company A was asked what they do with this information and refused to disclose, which is an acceptable answer.

Consider an example from Company A, a new hire has been in the hiring process since January, was informed they were hired around the first of April but was also told the next start date/new hire training class has not been scheduled due to COVID-19.  The employee is finally scheduled for a new hire class starting the first week of June.  Between the time of being hired and the start date, the employee begins taking classes Mon thru Fri, 1800-2100 (6:00pm to 9:pm).  The employee is scheduled to begin work at 1030 in the morning and work until 1900 (7:00pm).  The new hire asks for help with the schedule, the classes being taken will improve the employee’s skills upon graduation on the first of August.  Training is six weeks long, but the overlap is only 9 working days.  Company A’s response, either drop the classes or quit the job.

Internal-CS-Attitude-Low-ResThus, the attitude towards employee customer service is exposed to sunshine, and regardless of the games, prizes, food, swag, commissions, etc., the employee-customer service fails to keep highly talented employees.  This example is not new, and is not a one-off, unfortunately.  The example is regular business for employee treatment, and as the trainer stated, there are always more people for positions than positions open, so why should we change operations?  Since January Company A has been working unlimited overtime to fill the gap in open positions.

Company B informed all new hires that training is four-days long, and upon completion on the job training commences.  On day 3, training is extended to five days, on day 4 training is extended, and on Saturday, training is extended to a mandatory Sunday.  No excuses, no time off, no notice, and no reasonable accommodation is provided to make other accommodations for children, medical appointments, etc., and by the time Sunday arrives, the new hire class has already logged 60-hours in a week that began on Tuesday.  Several employees are unable to make Sunday and as such are now kicked out of training, and will lose their jobs once HR gets around to giving them the ax.

Neither employer offers reasonable accommodation to employees working from home, as working from home is an accommodation already.  Marking the first area of risk; if an employee works for your organization, regardless of the attitude of employee treatment, reasonable accommodation is the law in America, and similar laws are on the books across the world.  Yet, both companies were able to eschew the law and deny reasonable accommodation.  Company B did it by never responding to the employees after they missed a day of work during training.  Company A did it by forcing the employee to decide without the aid of HR, claiming HR does not have any power in the decisions of training.

Now, many people will advise the employees hindered in their job search that the company does not serve them.  That fit into a new organization is more important than money.  That if an employer does not serve their employees, that employer has no value and the ex-employee is better off.  Yet, the companies hired these people, went to great expense to onboard these people, and now must spend more money to hire more people to fill the gap.  Both companies will have to pay overtime and other incentives to get the newest new hires through training.  All because of the disconnect between serving internal customers and external customers.  Many business writers have said, the only customer business has, are the employees.

Leadership CartoonMyron Tribus used a water spigot to help explain the choices of business leaders where employees are concerned.  A business is either a money spigot and customers, employees, vendors, stakeholders, do not matter, so long as the money keeps rolling in to pay off the shareholders.  Or business is a spigot with a hose on it to direct the efforts of the business through the relationships with employees, customers, vendors, stakeholders, and shareholders, to a productive and community-building long-term goal of improvement.  Either a business is a money spigot or a community building operation, the business cannot do both.

With this analogy in mind, the following four suggestions are provided for businesses that either want to change spigots or need help building the only customer relationship with value.

  1.  Decide what type of business you want to be, and then act accordingly.  No judgment about the decision is being made.  Just remember, the greatest sin a business can commit is to fail to show a profit.  Employee costs can make and break employers and profits.
  2. Provide a feedback loop. Employees are a business’s greatest asset, the greatest source for new products, new procedures, new methods of performing the work, and new modes of operation, and until the leadership team decides the employees have value, the business cannot change to meet market demands.  In fact, that business that does not value employees, cannot change at all, ever!
  3. Be “Tank Man.” As a child, I remember watching the Tiananmen Square incident unfold in China.  I remember watching a man, stand in front of a tank and bring that tank, and several more behind it, to a standstill.  Nobody knows this man’s name, but many remember his stand.  Be the example of world-changing customer service, even if no one will ever know your name.Tank Man - Tiananmen Square
  4. Many parents have told their children, “Actions speak louder than words.” At no other time has these words been truer.  Act; do not talk!  Show your employees’ customer service and they will conquer the world for you.  Actions to take might not mean expending any money.  Showing someone you care is as simple as listening, and then helping.  LinkedIn daily has examples of hero employees who do more, serve better, and act all because their leader acted on the employee’s behalf.
    • Blue Money BurningConsider Company A for a moment, the time of class overlap was 1-hour. The number of days the overlap was going to affect that employee, 9.  Thus, for the cost of nine hours at $17.00 per hour, or $153.00 USD total, an employee was lost.  How much blue and green money was lost getting that employee hired, just to see that employee leave within two days of starting?  How much more blue and green money will be lost to replace that lost employee?

No longer can employer hope to treat employees poorly and still achieve financial success, between social media and modern communication, the word gets out that an employer does not care about their employees.  No longer can labor unions abuse non-union members autonomously.  No longer can a business walk away from social and community abuses with impunity.  The choice to treat people as valuable assets is an easy choice to make, choose wisely!

© Copyright 2020 – M. Dave Salisbury

The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the pictures.

All rights reserved.  For copies, reprints, or sharing, please contact through LinkedIn:

https://www.linkedin.com/in/davesalisbury/

Relieve the Suffering – I-CARE: Shifting the VA Paradigms

I-CareDuring my tenure as a medical support assistant (MSA) in the emergency room of the Albuquerque, NM VA Hospital, I took a class being offered on the new direction the VA customer service was going to embody called I-CARE.  I-CARE became my objective, as a customer service professional. As a dual-service/service-connected disabled veteran, I saw the abuses prevalent in the VA Hospital and wanted to change myself and provide mentoring to my co-workers in adapting I-CARE principles into their daily efforts.  Unfortunately, because of labor union interference, leadership failures, and supervisor efforts to counter I-CARE implementation, my efforts were discounted, denigrated, and derided until I was discharged from VA employment.  But, I-CARE remains a part of my commitment, my professional outlook, and personal commitment to customer service was forever changed by implementing the principles of I-CARE.

Leadership CartoonI write harshly about the crimes of the VA because I-CARE and deeply desire to see the VA bureaucracy changed, to witness the adoption of I-CARE into the daily efforts of every VA employee, and to see the VA leadership teams develop policies and procedures that will benefit the veterans, and relieve the suffering of veterans, their spouses and children, and live the VA mission of bearing up those who have born the pains of battle.

ProblemsI have seen veterans blithely refused prompt care because of the frequency that veteran had been seen, the lifestyle choices of that veteran, or simply because a charge nurse or doctor did not like the politics of the veteran as displayed by their clothing.  I have seen illegal actions taken to turn people away from care at a VA Hospital Emergency room by VA Police officers, charge nurses, and other nursing staff, and been powerless to stop these crimes because the hospital leadership refused to act, and became hostile to the employee’s reporting the problems.  I have witnessed leaders delete emails reporting problems as those emails were proof and evidence of crimes cannot be allowed to remain at the VA.  I-CARE about these issues; I report these problems, but because I-CARE I also provide solutions, easy fixes that could be applied and adapted for the relief of suffering and reduction of risk to the hospital.  My reports all were ignored while an employee, from the team leader to the director of Hospital Administration Services (HAS), to the hospital director’s suite, all sorts of deaf ears and crickets were in attendance.  I reported issues to the Veterans Integrated Service Network (VISN) which is a geographic group of VA Medical Centers under common leadership; also, to no avail, crickets, and deaf ears.

I-CareYet, I-CARE; still, I-CARE drives me and motivates me to see change occur at the VA.  To right the wrongs, and rebuild the VA.  One of my early leaders at the NM VA Hospital said something very prescient, “If a civilian hospital did half-the things the VA Hospitals get away with, they (the civilian hospital) would have been shut down and the leaders imprisoned.”  Having witnessed a year of crimes personally, seeing the inability for change to occur due to leadership, watching talent wasted, and monitoring the revolving door of employees in the VA, I concur with that statement.  The leader who spoke had 25-years of civilian hospital administration experience, before coming to the VA, and the VA would only hire this well-educated, highly experienced person as a GS-7, an entry-level employee.

Image - Eagle & FlagIn the coming days and months, I will continue to write about the VA.  Using personal experience, patient experiences related to or personally witnessed, and the Department of Veterans Affairs – Office of Inspector General investigation reports, as the reasons for the solutions I propose.  I-CARE, enough to stand as a witness that the VA in its current form cannot, and should not, be allowed to thrive any longer.  Change must come to the Department of Veterans Affairs (VA), including to the Veterans Health Administration (VHA; hospitals and clinics), the Veterans Benefits Administration (VBA; compensation and pension claims), and the National Cemeteries.  Thus, I witness my commitment to I-CARE and the VA.

© Copyright 2020 – M. Dave Salisbury

The author holds no claims for the art used herein, the pictures were obtained in the public domain and the intellectual property belongs to those who created the pictures.

All rights reserved.  For copies, reprints, or sharing, please contact through LinkedIn:

https://www.linkedin.com/in/davesalisbury/

The Department of Veterans Affairs: The Liars and Thieves Edition

I-CareIn December 2019, I witnessed an employee of the Department of Veterans Affairs, Hospital Administration, create rules to inconvenience a veteran, lie to a veteran, obfuscate, and generally mock a veteran.  The incident included the employee threatening the veteran with throwing away documentation, the primary care provider needed because the veteran was not mailing the forms to the doctor as the employee demanded of the veteran.  The veteran must travel and thought dropping off the forms would be acceptable; until he met this employee.  23 January 2020, I was the veteran being lied to, and my “cherub-like demeanor” evaporated faster than dew in a July sun.  For the December incident, I signed my name to a letter going to the Hospital Director Andrew M. Welch, written by the abused veteran, and testified that I witnessed the treatment this veteran received.  To the best of my knowledge, no action was taken by the hospital leadership where this employee is concerned, I asked.  A copy of this article will be sent to hospital leadership.  If any additional information comes available on this issue, I will write an addendum and update this article.

23 January 2020, 1505-1510, I went to my primary care provider’s clinic at the Albuquerque, New Mexico VA Hospital.  I had another appointment, was early, and went to ask why I am receiving letters claiming the primary care clinic is “having difficulty” contacting me.  The employee is titled “Advanced MSA,” which means they are a Medical Support Assistant who has been promoted.  For my other appointment, I have received two text messages, one automated call, and three appointment emails.  For my next appointment, 24 January 2020, I have received two text messages, one automated call, and three emails.  For my appointment in December 2019, I received two text messages, one automated call, and three emails.  I regularly receive calls from other clinics in the VA Hospital.  My cellphone has voicemail, and the voicemail is regularly checked and responses made.  Yet, the MSA claims, “I have tried calling you, and you do not have voicemail.”  I checked my recent calls, and showed the MSA where I had not received any calls from the VA on the days indicated, and asked why I can receive all these other calls from the VA, including the text messages, but only his calls are not showing up.  The MSA then became intransigent, resolute, and adamant, raised his voice, and told me our conversation was done.  After observing the ways and means of this VA employee over the course of many months previously, I wonder, “how many other veterans are not being contacted in a timely manner, while this person lies, cheats, and steals?”

Quality of FindingsUnfortunately, this is the standard, not the exception for the MSA’s in the HAS (Hospital Administration Services) Department, led by Maritza Pittore, at the Albuquerque VA Hospital.  I have witnessed multiple MSA’s committing HIPAA violations through record diving, gossiping about veteran patients, acting rudely, ignoring veteran patients and their families to complete conversations, and refusing to do their jobs.  As a point of fact, one assistant director one told me, “if what the VA does was replicated by a non-government hospital, they would be closed down and sued.”  While employed from June 2018 thru June 2019, I brought this to the attention of the leadership, including multiple emails and voice conversations with Maritza Pittore, Sonja Brown, and several other high-ranking leaders and their assistants, all to no avail.  I have had nursing staff tell me confidentially that they cannot do anything where the MSA’s are concerned because “it’s none of their business and outside their job duties.”  Yet, the VA continues to proclaim the MSA, the Nurse, and the doctor, along with the patient, are a “healthcare team.”  Upon being discharged, without cause, reason, or justification, I brought this information to the OIG, my congressional and senate representatives, among many others, all to no avail.  The level of customer service, especially at this VA Hospital, is far below the pale because the leadership refuses to engage and set standards for customer service, with enforced penalties. I-CareMore to the point, the employees mimic the customer service they receive from the leadership team.  Thus, even though the Federal VA Office has launched “I-Care” as a customer service improvement initiative, the customer service in this hospital continues to fall and will continue to fail until the leadership exemplifies the standards of customer service expected.

As a dedicated customer service professional, I have offered multiple solutions to the continuing problems veteran patients experience in the Albuquerque VA Hospital at the hands of the MSA’s and other front-line customer-facing staff; but the suggestions all continue to fall upon deaf ears.  I do not paint all the MSA’s and staff as liars, thieves, and cheaters, because there are some great people working at this VA Hospital.  Unfortunately, the rotten apples far exceed the good workers by multiple factors and powers, to the shame of the leadership team who continues to ignore the problem, deleting emails, and generally lying when placed on the spot about the problems.

An example of this occurred recently where a member of the staff of a congressional representative asked about communications sent from an employee to the Director of VISN 18, with carbon copies being sent to Maritza Pittore HAS Director, Ruben Foster MSA Supervisor, and Sonja Brown Associate Director of the Hospital.  None of those emails “magically” exist when asked for, and the verbal conversation included outright lies, misdirection, and complete fallacies.

Since the VA-Office of Inspector General (VA-OIG) continues to appear disinterested, I can only ask, “what does a person do to see action taken to correct the problems, right the abuses, and bring responsibility and accountability to the employees of the Federal Government?”  President Trump is providing great leadership, VA Secretary Wilkie is doing a good job and needs more help, but the elected officials in the House and Senate refuse to do their job, and the middle management of the VA is entrenched, obtuse, and inflexible.  The US Media treats veterans’ issues as a punchline to a bad joke.  Still, the problem worsens; still, the abusers maliciously treat people abhorrently; and still, those placed in leadership positions stall, obfuscate, and hinder.

My treatment at the VA Hospital in Albuquerque includes being physically assaulted by an employee, my medical records perused by, and then gossiped across at least four separate clinics, and still that MSA remains employed.  In fact, this employee was promoted for her “good work and dedication to helping veterans.”  I am sick and tired of the poor treatment, the harassment, and the vindictiveness served to veterans of all types, sizes, and colors, at the hands of petty bureaucrats as they visit the Department of Veterans Affairs.  The Albuquerque VA Hospital is one of the most egregious examples of bad behavior and nepotism in the country and it is past time the leadership was replaced and the assaults and crimes brought into the sunshine for some “sunshine disinfectant.”

cropped-snow-leopard.jpgUpdate to this article, 10 May 2020: By the first week in April 2020, the Advanced MSA in the clinic was moved to a less customer-facing post and a new MSA hired.  The quality of that individual was never experienced due to relocating.  The supervisor of the MSA was not very interested in correcting the problems and that showed when I visited with them while trying to obtain an appointment that the Advanced MSA refused to schedule.  Change must come to the VA!

© 2020 M. Dave Salisbury

All Rights Reserved

The images used herein were obtained in the public domain; this author holds no copyright to the images displayed.

Honest Praise – Catch Your People Doing Good!

My professional library has many books, from many authorities, regarding how to lead, leading in change, crisis leadership, and more.  Except that none of these books ever discusses the most critical tool in a leader’s toolbox, issuing honest, timely, and relevant praise.

I am one of those people who had to repeat a grade in school, and I am glad I did, for it provided an opportunity to meet Miss Murphy in the Governor Anderson Elementary School, Belfast, Maine.  Miss Murphy has a smiling face, but you know there is a stick hiding nearby if needed.  Miss Murphy laughed and smiled, and was the first principal I had witnessed behaving in this manner.  Miss Murphy had laser eyes that sparkled with mirth and could freeze rushing water.  Miss Murphy was a nun who went into the world to make the world better, especially for children.

As an energetic person, a person with problems with authority, and a guy, I spent an inordinate amount of time in the principal’s office in school.  Please note, I am not bragging here, just recognizing an “uncomfortable truth.”  Miss Murphy related a story to me, from her childhood, about how she had been called to be a student crossing guard, where she exercised her authority a little too much, and some kids cried, parents called the school, and complaints were issued.  Her school principal called her into his office, she could clearly see on his desk the complaint forms, but her principal spent more than 10-minutes praising her leadership ability, her genuine care for smaller kids, and other observations where her good personality had been witnessed.  Miss Murphy claimed she left his office forever changed.

The day Miss Murphy related this story to me, she praised me.  I knew that she knew, I had heckled a teacher mercilessly in an unwarranted manner.  I knew that she knew, I had committed several other offenses needing her judgment and punishment.  Yet, she provided honest praise, where she had observed quietly, and she concluded this visit to her office with the words, “From these observations, I know there is good inside you.”  I can honestly say, this was the worst chewing out I ever had in a school principal’s office.  I left her office that day, feeling small and insignificant like never before, but also feeling like a million bucks and dedicated to being caught more often doing good.  More to the point, I had discovered what a leader is and made a friend that I wanted, desired, and hoped I could receive more praise from.

To the leaders in business, I would make the plea, “Catch your people doing good.”  Catch them regularly, praise them honestly, issue the praise promptly, and you will shortly see new behaviors, attitudes, and cultures in your workplace.  I have published this plea previously and been asked some questions, below are the questions and some examples to get started.

  1. Isn’t all praise honest?
    • No, all praise is not honest. A pernicious lie has been passed around that criticism can be constructive; this fallacy needs squashed forever and cast upon the bad ideas from history.  You cannot build people by criticizing them.  There is never anything “constructive” in criticism!
    • Honest praise is precisely that, honest and sincere. You mean what you say, and say what you mean.  Hence, when you feel thank you is insufficient, leave a note in a distinctive color praising the efforts observed.
    • For example, I witnessed a leader who used praise to help ease the pain of failure. A subordinate had worked hard to make a satisfy a customer and fix a problem caused by the company.  The customer refused the apology and swore revenge, making the efforts of this customer agent useless.  The leader recognized the efforts and issued praise for trying, for being a generally successful customer advocate, and for going above and beyond.  The customer agent never realized someone beyond their team leader had observed their efforts, and the employee broke down in tears of gratitude for the honest praise issued.  I personally witnessed renewed dedication from this employee, and the impetus for change was the note of praise.
  2. Timely praise; why does praise need to be timely?
    • Timely praise is all about recognizing and issuing praise while the events are still fresh, and when the praise issued has a real chance at affecting an individual’s future efforts. Timely is all about being engaged in that exact moment and stopping to recognize, through praise, the efforts, trials, and experiences of others.
    • I worked at a company for three years, in what became my last quarter, I was issued praise for actions taken during my first month on the job. Honestly, that praise was useless to me, and while I didn’t fully spurn the efforts at recognition, I certainly was not swayed, inspired, or even influenced by the praise issued.  However, other incidents where praise was issued timelier has been more influential; thus, the need for timely praise.
    • The employee mentioned above, the effort expended occupied time Monday through the disastrous conclusion on Thursday. The employee came in to find praise and recognition on Friday Morning.  Timely, honest appreciation, proved to be what was needed and changed a life.
  3. Why should praise be offered regularly?
    • Let’s be honest, issuing praise adds work to your day. You have to make observations, then you have to issue praise, and this is a generally thankless effort; especially when you have to “Wash, Rinse, and Repeat” countless times to visualize a return on your time and effort investment.  I guarantee this effort will not last, no changes will be realized, and this attitude will be observed to cause more problems, not less.
    • Let’s be honest, issuing praise is fun. Witnessing a person who has been caught doing good provides excitement to replicate.  Catching a person doing good provides me a pleasure valve release from the stress of meetings, monthly and quarterly reports, and the hassles of leading an organization.  Issuing praise allows me to get out of my office, make human contact, and enjoy the people side of my job.  I guarantee this effort will last, that deep life-altering impact will be felt by those working for this leader, and employee problems will reduce to the lowest common denominator.
    • Regular praise issuance means you are fully committed to giving praise, and this effort will be reciprocated in a manner unexpected. Like the contagious smile, issuing honest, timely, regular praise, will catch fire and the contagion will spread and permeate throughout the office like wildfire.  Your customers will even catch the disease of issuing praise.
  4. Isn’t issuing praise just “puffery” or building snowflakes?
    • No! A thousand times; NO!  Honest praise, timely issued, and regularly provided is not “puffery,” but a direct extension of how you feel towards another person.  A child brings their mother a dandelion.  Does the mother squash the flower as just messy, or takes the flower and doesn’t issue thanks to the child; no.  Why should workplace praise and gratitude be any different than the child and their mother?
    • Issuing praise and showing gratitude is treating others how you prefer to be treated. Do you like seeing your efforts recognized; then recognize others.  Do you like being provided expressions of gratitude; then pass out gratitude.  People take cues from their leaders’ actions more than their words; issuing praise and recognition is an action with monumental power.
    • Myron Tribus asked a question about the purpose of a business essentially asking, “Is the purpose of your business to be a cash spigot or to improve the world?” If cash spigot, you would never issue praise or gratitude, and the money is the only focus.  In this scenario, expect high employee churn, higher employee stress, and poor employee morale.  If the purpose is to build the world, why not start by building the internal customer?  Do you issue thank you’s to your customers; why not issue gratitude first to your internal customer, the employee?
  5. Do adults, and working professionals really need all this praise?
    • Mark Twain said, “I can live for two months on a good compliment.” Yes; working professionals do need to be praised.  However, because they are adults, false praise, criticism couched as praise, and fake praise is easily detected, and the resulting consequences are terrible to witness.
    • While serving in the US Navy, I experienced a Chief Engineering Officer who faked praise, criticized through praise thinking he was constructive, and his efforts turned the Engineering Department’s morale from high to depressing in less than seven days. The Engineering Department went from winning awards and recognition to absolute failure in inspections, drills, and daily activities in less than two-weeks.  The recovery of the Engineering Department’s morale never occurred in the remaining two-years I had in my US Navy contract and featured a big reason why I left the US Navy.
    • Thus, to reiterate; YES! Yes, adults need honest, timely, and regular praise.  Yes, praise is a tool that can be wielded to effect significant positive change or can be wielded to decimate and destroy.  Choose wisely!

 

© 2019 M. Dave Salisbury

All Rights Reserved

The images used herein were obtained in the public domain, this author holds no copyright to the images displayed.