Remember the Captivity of your Fathers: A Paradigm for Freedom!

RememberTo remember is to do something that is necessary or advisable which brings honor to the past and freedom to the present.  Remembering is the power of becoming aware that you are more than the singular person and many others have held a hand in making you, your personality, your strengths, and your weaknesses.  A greeting card reads, “I am a strong person, because a strong person raised me.”  Remembering is also the power that propels the person from their starting point into a glorious future.  Ralph Marston has the last word on remembering, “Remember why you started, remember where you are headed, think how great it will be to get there, and keep going.”

The Church of JESUS CHRIST of Latter-Day Saints, revers as scripture “The Book of Mormon: Another Testament of Jesus Christ,” in which the reader is encouraged to “Remember the captivity of your fathers” (Mosiah: 27:16; Alma: 5: 6; Alma 29:11-12; 36:2, 29).  The captivity originally spoken of was physical captivity, where a group of people had been militarily taken over by their enemies and were in physical bondage, slaves pressed into cruel service.  But, as this theme evolves the reader is encouraged to remember other types of captivity their fathers have been subjected to, as a means of more fully enjoying the freedoms and opportunities they possess, because of their father’s captivity and release from captivity.

To the person escaping Cuba as Castro came to power, the captivity of communism and the celebration of freedom in America is a tangible memory, and powers many a child to act.  The release from concentration camp captivity powered and motivates even to this day the children and communities where freedom now rings.  The captivity of those in the USSR powers the minds and freedoms of those living in Russia.  Problems still exist, but the freedom from captivity is worth remembering, and by remembering, honor is paid to those who suffered that captivity, by the growth and development of those present and in the future.

CaptivityCaptivity comes in many shapes, by many names, and is visible only through the suffering of those held captive.  For example, during a conversation with several older adults, I asked a question about the captivity of illiteracy and asked how many generations back in their families does it take to find an illiterate family member.  One very lucky person it was more than 8 generations, another said three, a couple said four, but a very elderly person in the back said 1, his parents never learned to read or write in their own native language or English.  This man is a Native American from a tribe in Northern Arizona, when I met him he was in his late 80’s.

As a child of 8, he was separated from his tribe, his family, and the reservation he knew, loaded onto a bus, and sent to Oklahoma for education.  He spent 10-months of every year for the next 10-years, going to school in Oklahoma.  During which time he never received a single letter from his parents.  Was not allowed to speak his native language, and all native culture was forbidden.  He credits this traumatic period of his life as the crucible for all the good that has come to him through education.  His children and grandchildren, all successfully completed college becoming engineers, lawyers, doctors, nurses, and more.  He had two great-grandchildren just entering college, and his first great-great-grandchild was soon to be delivered.

On the topic of remembering the captivity of his fathers, their illiteracy, he remembers every day in gratitude, even though his parents’ thirst for learning meant he endured such harrowing experiences to go to school.  The captivity of his fathers, drove and motivated him to ensure his progeny would not suffer the same captivity.

Another example, similar question about the captivity of their fathers, how many generations back before your fathers never left a small plot of land, whose only views of the world were restricted to that single plot of land.  One answered, his grandfather had been hated by his family for leaving a place of comfort in Scotland, for a rough life in the western states of America.  Many of his family only ever saw the titles, the land, the benefits, and wanted those things.  The family desiring these things never saw the captivity and the family remains broken and separate to this day.

What was the captivity the grandfather escaped from if he had land, titles, money, servants, etc.; freedom to grow, change, and become.  As long as his family stuck to the same life and ways of his fathers, they would have a comfortable physical life.  Herein lay the captivity and this gentleman tells his story as a caution about researching family history.  I have always held this story, not as a caution, but as a parable regarding individual choices.  Born into freedom and plenty, but requiring ceaseless toil, members of this gentleman’s family preferred captivity and luxury to hard work and accomplishment.

Government Largess 2I see the welfare state in America that strips pride and accomplishment and replaces it with appetite suppression, and I see millions in captivity.  A captivity that breeds wasted and blasted lives, people who have potential dying under government handouts, forever stuck in subsistence living and not knowing how to escape the captivity of their choices.  Where for the work requirement for welfare that same person would know and understand different lessons and potentially choose a different path; thus, discovering that through work captivity is broken.

I see the captivity of thought, children raised in homes as rigidly controlled as Nazi Propaganda, controlled by the captivity of hate and choices of parents, and becoming leeches and vermin to America’s health.  Consider upon the state of these children and weep for their lost innocence and America’s future.  These are the children in the streets since May throwing bricks, lighting fires, attacking helpless victims, and causing such tremendous violence upon the American Soul.  Look upon these children in mental captivity and remember, “But for the grace of God go I” (John Bradford).

Government Largess 4Other types of captivity our fathers suffered, and our children are suffering includes, mental/physical/sexual abuse, drugs and alcohol, criminal activity, gangs, single-parenthood, the loss of the nuclear family, technology, and so much more.  Why should a person remember the captivity of their fathers?  Because by remembering by recommit to not passing along that captivity to our children or communities.

The Old Testament carries a similar theme to remembering the captivity of our fathers, when the children of Israel were commanded to remember the Passover.  Yom HaShoah (יום השואה) and in English as Holocaust Remembrance Day, or Holocaust Day, is another holiday set apart for remembering the captivity of our fathers and recommitting to freedom from oppression.  Buddhism has Bodhi Day upon which the full day is set apart for remembrance and meditation.  Catholics have All Souls’ Day as a day for remembering the past, honoring the lives of loved ones lost, and recommitting to a brighter future.

LiberationThese holidays are mentioned, and more exist, to aid the reader in understanding the importance of remembering the captivity of our fathers.  America’s fathers have fought much, and bled much, suffering incredible injuries, all to make the future better.  Can we, the recipients of these sacrifices to shed captivity, do less and lose this great Republic, without suffering the indignation of our fathers in ages past?

Consider the frozen feet and fingers of Valley Forge; what was a little frost bite when compared with the glorious vision of freedom to the soldiers on duty there?  Consider the bloody battles of the Civil War, the fear, the anger, the soul shattering pounding of the guns; both sides consider themselves correct, both sides wanted a vision of freedom, but only one side could win, and in winning bring complete freedom to all the people of America.  Consider the soldiers, sailors, airman, and marines in Afghanistan, South Korea, Africa, and every other place America sends her military might, can we sit at home comfortable and not feel gratitude for their sacrifices, the cold they suffer, the wounds, the physical and mental strain?

Image - Eagle & FlagRemembering is an action, a thought process with impetus power to drive commitment and action in an individual.  Let us not forget the captivity of our fathers and by remembering act in a method that will secure liberty, justice, and freedom for our children’s children.  America is in danger of being lost; this great republic, blessed with a Constitutional form of government is in danger.  I for one, refuse to sit idly by and lose this precious country; I implore you to remember the captivity of your fathers, and join me in voting intelligently, join me in throwing off the shackles which threaten to bind us down in captivity to communist and socialist styles of governance.  Join me in taking back America!

© 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/

 

August VA-OIG Updates: More SHAMEFUL VA Conduct.

I-CareDue to personal issues with the Department of Veterans Affairs (VA), specifically the Carl T. Hayden VA Medical Center (VAMC) in Phoenix, AZ I fell a little behind in June/July/August of 2020.  As I work to clear the backlog of completed Department of Veterans Affairs – Office of Inspector General (VA-OIG) reports from August, please keep in mind solutions to these problems are available. The failure of leadership to be held accountable, by the elected officials is staggering, and the lack of accountability and responsibility boggles the mind.  Without exception, I know the VA can be improved, developed, and saved.

August 2020 begins with an individual employee making a decision regarding healthcare decisions for a veteran at the Robley Rex VAMC in Louisville, Kentucky.  The VA has a process where individuals can be allowed to be surrogate decision-makers for a veteran who needs additional assistance.  This process works is legal and is a great tool for family and friends of veterans to play a significant role in the healthcare process of the veteran.  In this instance, the process failed, not because the process was bad, but because people did not do their jobs properly.

The VA-OIG assessed an allegation that providers permitted an individual with no legal authority to make medical decisions on behalf of a patient, and a host of other patient rights were trampled as documented.  “The patient experienced a three-week medical and mental health hospitalization with repeated episodes of confusion, agitation, and combative behavior. The patient was transferred to hospice care and died five days later.  The VA-OIG found that facility staff did not take the required appropriate steps to identify and confirm the eligibility of this surrogate.  The VA-OIG determined records did not contain sufficient documentation of physicians’ clinical assessments to support diagnoses and treatment decisions. Clinical communication and collaboration were inconsistent, insufficient, and negatively impacted the patient’s continuity and quality of care. Providers did not consistently document medication monitoring and oversight activities to ensure safe patient care. The patient’s transfer to hospice was completed without fully pursuing other diagnoses and treatment options and staff did not ensure the patient’s rights were upheld regarding involuntary admission and behavioral restraints. Facility leaders did not complete a thorough quality of care review to understand the reasons for the patient’s atypical hospital course and outcome” [Emphasis Mine].

Many times, the VA-OIG reports do not clarify all root causes due to employee privacy; however, from the report, the employees who repeatedly allowed the neighbor to make healthcare decisions were exceeding their legal bounds and made decisions that harmed the patient.  This veteran died and from the report, it is clear the veteran died confused, possibly due to medication changes, and the family was not notified in a timely manner because the neighbor, without legal and written authority, was allowed to make healthcare decisions for the veteran, even though there was written healthcare directives on file for a family member to make these decisions.  Utterly shameful behavior!

PatriotismThe Veteran Integrated Service Network (VISN), is a geographical grouping of VA Healthcare Systems, e.g. hospitals and clinics, under a combined leadership plan.  One of the tools the VA-OIG uses to monitor the quality of patient care inside VISN’s is called a “Comprehensive Healthcare Inspection Program (CHIP).  CHIP covers selected clinical and administrative processes all of which are deemed consistent with promoting quality patient care.  The CHIP occurs on a rotational 3-year periodicity and the focus is shifted slightly each 3-year cycle to, theoretically, encompass all administrative processes over time.  The VA reports the following are the specific areas that lead to quality patient care through administrative practices:

  1. Quality, safety, and value;
  2. Medical staff privileging;
  3. The environment of care;
  4. Medication management (specifically the controlled substances inspection program);
  5. Mental health (focusing on military sexual trauma follow-up and staff training);
  6. Geriatric care (spotlighting antidepressant use for elderly veterans);
  7. Women’s health (particularly abnormal cervical pathology result notification and follow-up); and
  8. High-risk processes (specifically the emergency department and urgent care center operations and management).

All of which is mentioned as an explanation providing details for the following VA-OIG inspection reports of CHIP received in August 2020.  A total of seven CHIP reports were received in August recording performance from inspections carried out.  These reports, while somewhat individualized for the specific VAHCS, reads like a carbon copy.  Repeatedly written procedures for standard operation are missing, staff training is inadequate or antiquated, risk analysis is not able to be competently and correctly conducted, patient safety issues abound, and the proper utilization of management processes remains glaring!

Root Cause AnalysisThe CHIP reports are so repetitive in nature, the VA-OIG recommendations are grouped, conveniently, into the eight administrative areas listed above.  According to proper management techniques, the VA-OIG then “encourages” the leadership team to select one or two areas for improvement and focus their efforts on leading change in those areas.  For example, if the VAHCS wants to improve in risk analysis, the leaders can begin by promoting training on properly conducting risk analysis online, hold meetings to review risk analysis procedures and begin to train and develop staff on improving n this area.

However, here is where reality meets theory, without written standard operating procedures risk analysis cannot be completed properly.  The bureaucracy protects itself and will thwart the implementation of written standard operating procedures as this removes designed incompetence that keeps the bureaucrat in power at the VA.  Thus, the root cause of improving root cause analysis is the lack of written procedures that measure performance against a single written standard.

CHIP Report after CHIP Report the same issues arise, are noted, recommendations from the VA-OIG are documented, and the same response is supplied; this represents the epitome of designed incompetence and the root of the problem the VA is facing.  Recommendations for improvement have been repeatedly provided and change can occur; but, not without dedicated leadership, not management, to thwart the bureaucratic quagmire that the VA has fallen into.

Leadership CartoonAnother regular entry on the CHIP reports is the following: “Employee satisfaction scores revealed opportunities for the Associate Director for Patient Care Services to improve employee attitudes towards senior leaders.”  Here is the problem, how many of the “senior leaders” are less than managers, promoted beyond their maximum level of incompetence, solely because they were the next warm body in line; too many!  When staff training is a repeated issue on CHIP reports, one must ask how employees are being measured?  Where are the written scorecards that reflect a process that was used to measure employee performance fairly and equitably?  Was the employee trained on how to perform their role according to the standards published?  Do the scorecards reflect that all employees have been trained, measured, and reported equally?

Guess what, since staff training remains a consistent problem, the staff leaders are the problem!  A major part of “Quality, Safety, and Value” is “Leadership and Organizational Risks.”  A lack of training in properly, timely, and correctly performing one’s role as hired is both a leadership and an organizational risk.  Failing to train employees is the absolute worst comment a leader should be informed of by a third-party inspection team.  Yet, the training of staff is consistently the root cause after a lack of standardized operating procedures.  Every mid-level supervisor, trainer, manager, director, etc. titled individual at the VA should be embarrassed when told their staff is untrained; but, it appears these same leaders do not care!

The Duty of AmericansHow can a person draw the conclusions that the VA appears to not care about improvement, or that the lack of caring is rampant across the entire VA structure; look no further than the site visit VA-OIG inspection report of the Department of Veterans Affairs – Veterans Benefits Administration (VBA).  The deputy undersecretary for field operations expected regional office managers to be aware of issues raised in other regional office site visit reports, but there was no written policy for addressing frequently identified errors.  So, the mid-level regional office managers must be told to investigate internal websites to gather lessons learned and apply those lessons in their regional offices.  What an incredibly inept excuse; shameful conduct by a senior leader, and how much worse does this attitude become as it filters down to the troops?  The behavior that claims a new policy is needed to improve performance is utterly bereft of logic and demonstrates the lackadaisical attitude being discussed.  Then these same leaders wonder why their staff is disengaged, disconnected, and distrusting of leadership; unbelievable!

One of the first lessons I learned in becoming a business professional was, “If you have to write your ethics down, you have already lost.”  The VA policies on ethics, ethical conduct, and ethical behavior are voluminous, trying to cover every detail, every loophole, every issue, and mostly the VA-OIG reports on ethical breaches reflect individual poor judgment at best, and designed incompetence at worst.  Yet, still, the VA tries to implement ethics without a source, moral behavior without a purpose, and the individual employee is left with plenty of excuses for not behaving in a properly ethical manner.  This is the topic of another article; but it must be made clear here and now, ethical lapses continue to abound at the VA.  From the nurse not giving drugs to patients and selling the drugs on the street, to hospital directors not disclosing what appears to be a conflict of interest, the VA remains afloat on a sea of ethical violations.

The remaining reports in August reflected an investigation that the VA-OIG was unable to substantiate due to a lack of reports filed in a timely and proper manner.  More designed incompetence on the part of the VA.  Also included in these final reports were more repetitions of issues discussed where staff training was the root cause for ethical violations, failure to properly perform duties as hired, and staff training was the problem with adherence and compliance issues.

The disconnect is obvious, and the direction forward is clear.  Hospital Directors, write the standard operating procedures, using the resources of how the work is performed currently as the baseline.  Then begin correcting and amending the written procedures over the following year to improve performance to a written standard.  Once the written standard is completed, e.g. the baseline, begin training of staff.  You cannot measure individual performance without standards, and standards cannot be followed without written operating procedures for conducting business.

Behavior-Change© 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/

July Updates: OIG Reports That Should SHAME the VA!

Survived the VALate last week, I received a call from the Chief of police at the Phoenix VA Medical Center.  In July, I had been arrested for not wearing a mask.  By late August, I had figured the Phoenix VA Medical Center Director was going to just “forget me” and hope I go away, then the call comes in.  The Chief of police begins by stating, “I do not know why I am calling you, but I was requested to call and see what I can do to help.”

This response of the chiefs can be viewed two ways, he honestly does not know and needs to be updated, or he is using this as a conversation starter and does know.  I choose to see the best in people and gave the chief the benefit of the doubt.  I explained the situation, the multiple different stories regarding “VA Policy on Mask Wearing,” my multiple visits where I was not hassled about not wearing a mask, the confusion with the face shield, and the behavior of his officers in trying to implement poor policy.  To which the chief replied, I cannot help here and will return this issue to the director’s office where I had initially filed the complaint.

I do not blame the VA Police for arresting me.  They are tools of policy, as I have discussed previously and you can review here.  The police in my situation are stuck in the middle between a ridiculously inept hospital director, and the need to enforce the policies which issue forth.  At the beginning of COVID-19 hysteria, the director received a memo from the Department of Veterans Affairs (VA) regarding how to handle COVID-19.  The director did not adapt the policy to the local hospital, placing patients at risk who wears a mask in Phoenix summer conditions; nor, did the director include the ability for individual adaptation to individual patient health concerns, SAIL Metrics.  Thus, the VA Police are stuck, they cannot allow exceptions, they cannot allow for individual accommodations, and this places more burden upon the veterans seeking and requiring care at the Phoenix VA Medical Center and clinics.

The VA provides the rating of VA’s and the following website: Why not the best VA which will easily explain in a numeric format the indicators of problems with each VA.  What I find interesting is how many times the worst VA hospitals find themselves on the Department of Veterans Affairs – Office of Inspector General (VA-OIG) for egregious breaches of common sense, customer service, and common decency.  The Phoenix VA Medical Center is in VISN 22, and knowing the various hospitals intimately in VISN 22, the only conclusion possible in reviewing the data is that the 8 different hospitals in VISN 22 are in a dead heat race to the bottom, and the Albuquerque NM VA Medical Center is the best of the worst.

Carl T. HaydenThe VA-OIG conducted a healthcare inspection at the Atlanta VA Health Care System (VAHCS) in Decatur, Georgia, and found they had a backlog of open community care consults, and the OIG found deficiencies in processing, scheduling, and timeliness of these consults. Important to note, the contributory factors included but were not limited to, inconsistent scheduling processes, inconsistent oversight, and deficiencies with third-party administrator scheduling oversight, shortages of scheduling staff, and lack of training and supervision for scheduling staff. The facility did not consistently meet facility process requirements for scheduling audits and lacked a process to identify consults that were missing documentation after administrative closure.  While the Decatur VAHCS should be praised for not having any critical patient concerns due to the scheduling failures, this appears to be more luck on the patient’s part, than efficiency on the scheduling staff part.

The VA-OIG conducted a healthcare inspection at the Nashville VA Medical Center in Tennessee to evaluate alleged deficiencies in cardiac telemetry monitoring services including policies, staffing, and communication.  The facility should be praised for its progress in fixing deficiencies without the recommendations of the VA-OIG investigatory team.  The facility leaders also deserve praise for their attention to details, improvements in communication, and other facility improvements made since Feb 2019.  The last time this facility made the VA-OIG inspection report, the investigation was not pretty and their improvement needs to be praised; while more progress is needed, congratulations on the progress made.

Speaking of providing praise where praise is due, the VA-OIG conducted a comprehensive healthcare inspection of the Kansas City VA Medical Center (VAMC) and multiple outpatient clinics in Kansas and Missouri.  While this VAMC and outpatient clinics still have significant growth in improving SAIL metrics, they have progressed and growth is happening.  I send my regards, and sincere congratulations on the progress made.  I also wish them the best in continuing to improve.  This VAMC has a long road to recovering, but I know with patience, improved organizational design, and better staff training, they can get where they need to be.

ProblemsImagine you’re a patient, or worse a family member escorting the patient, with suicidal ideation, and you hear the doctor say, “the patient can go shoot themselves. I do not care,”  How would you feel about the 12-hour stay in the Emergency Room, after seeing seven different providers who did not read the notes, complete adequate patient handoff between the ER and outpatient mental health, which also includes deficiencies in the hand-off processes, and providers’ failure to read the outpatient psychiatrist’s notes, which led to a compromised understanding of the patient’s medical needs and a failure to enact the outpatient psychiatrist’s recommended treatment plan.  Completing six-days later in the veteran taking their life.  This exact scenario should NEVER have occurred but did at the Washington DC VA Medical Center.  Now, the physician making that detestable comment had previously made similar comments about other patients; crickets from leadership.  The ER physician making this incredibly obtuse statement has a history of making “inappropriate comments” about patients in the ER, and this has been known to leadership since Feb 2019.  No action, no investigation, no remediation, and now we have a dead veteran because the representative of the VA had the gall to say, “the patient can go shoot themselves. I do not care.”

I-CareWhen any veteran dies by their own hand, it is a tragedy.  But, when the VA has any responsibility in that veteran committing suicide, heads should roll, individual people should be held accountable, and in this case, especially, criminal proceedings should commence!  I worked in the VA ER, I know what the providers, nurses, and other staff providing patient interactions say.  I have reported several inappropriate comments that the patients heard to no avail, no recourse, and no action by hospital leadership.  I know, intimately, the political chicanery that occurs at the VA, and I can tell you, this IS a pet issue with me, and I am unapologetic in calling for criminal charges on these providers who are abusing veterans and their families!

Leadership CartoonThe VA-OIG inspected the VA Illiana Health Care System (VAHCS) and multiple outpatient clinics in Illinois.  The VA-OIG also inspected the William S. Middleton Memorial Veterans Hospital and multiple outpatient clinics in Illinois and Wisconsin.  I have been in both and I can say unequivocally, more progress is needed and the leadership desperately needs to improve professionalism among staff, improve patient safety from the bureaucrats not providing care, staff competencies, and staff training.  All of which were among deficiencies mentioned by the VA-OIG.  There is great potential in these VAHCS’ for achieving greatness, but the bureaucrats need deep cleaned, and removed!

What continues to astound me is the replication of excuses and issues between VAMC’s and VAHCS’ when these comprehensive healthcare inspections are conducted.  On average, I can expect 3-5 comprehensive healthcare inspection results from VA-OIG per week in my email box.  Yet, the same exact issues and excuses are used time after time, location after location.  Those VAMC’s and VAHCS’ who are failing know they are failing, and the lack of care witnessed by the inaction of the hospital leadership infuriates this veteran.  Leaving me asking, “Who will care enough to demand change and cease allowing these tepid and weak excuses to be allowed?”  Are the elected officials even looking at the repetitive nature of the issues and asking follow-up questions, demanding answers, or even bothered by failures in comprehensive healthcare inspections?

I have not personally visited or been a patient in the following VAMC; however, the stories I hear from my friends and colleagues tell me the VA-OIG might have missed a few indicators of problems in this inspection and bought the excuses for designed incompetence.  The VA-OIG conducted a review at the Ioannis A. Lougaris VA Medical Center in Reno, Nevada. The review proactively identified and evaluated declining performance metrics that could affect the quality of care and patient safety.  The staff blamed the falling metrics on “losing focus, staff pay, other change initiatives, inefficient processes, which all contributed to performance deficits.  These are standard excuses for designed incompetence and I refuse to accept these conclusions by the VA-OIG.  Will the Ioannis A. Lougaris VA Medical Center in Reno, Nevada be the next Phoenix, AZ VAMC to kill a couple hundred veterans before these excuses are no longer accepted?

VA SealThe behavior of the VA as recorded in these VA-OIG investigations and inspections continues to reveal significant problems with staff, where the staff has designed processes and procedures to allow a ready excuse for any problems that arise and continues to prove that a veteran takes their life in their hands when visiting the VA.  These actions must cease forthwith.  There is no excuse for the behavior investigated and reported.

© 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/

Apathy, Empathy, and Sympathy: The Emotions of Ruination

Of all the titles I have been branded as a professional, one that holds the most truth is that I am heartless.  I do not share your emotional choices; thus, to you, I am heartless, and I will not invest my time to dissuade you otherwise.  Emotional outbursts have somehow become popular, and it is my intent to reduce the amount of emotional blather found in the workplace, as an extension of real emotional intelligence.

Empathy v ApathyApathy is all about a lack of enthused concern.  Being apathetic is a choice to show no concern, emotional connection to an issue, or interest.  The choice to be apathetic is personal and does not indicate that a person is heartless; simply, that the person being apathetic is making different choices where emotion is concerned on a topic.

Empathy, of all the emotional pitfalls empathy, is the most devious of the emotional tools on this list.  Empathy is all about acting like you understand the emotions of another person, and you have a personal desire to share in those emotions.  Empathy is fake; empathy is a choice one exercises in an attempt to control a person or situation through emotion.  Being empathetic is a skill set learned as a manner of defense or, for the more nefarious, to control others.  Empathy is nothing more than faking concern, justifying the emoter’s emotional responses.

Sympathy is a process of coming to a common feeling.  The emotional pathway journeyed by people or groups, to feel the same sorrow for someone else’s misfortune.  Sympathy is the most dangerous of the emotional tools on this list, not for the one experiencing the sorrow or misfortune, but for those who jump in with the person feeling the sorrow or experiencing misfortune.  Understand, the sympathetic person attracts other sympathetic people, like moths to a flame, or lemmings to a cliff.

Sympathy v Empathy v ApathyHere is the problem with all three emotional tools above, they are emotional responses to external situations.  Jean-Paul Sartre is quoted thus:

For the idea which I have never ceased to develop is that in the end one is always responsible for what is made of one.  Even if one can do nothing else besides assume this responsibility.”

Robert Solomon made Sartre’s quote above more meaningful when a person considers that, “Emotions involve social narratives as well as physical responses, and an analysis of emotions is an account of our being-in-the-world.”  The freedom to “make of one” does not include showing no emotion, nor does it mean that one must partake of every emotional current that swirls and eddies around a person during a typical day.  Solomon continued by empathetically stating, and supporting that, “Emotions are not occurrences and do not happen to us… emotions are rational and purposive rather than irrational and disruptive, are very much like actions, and that we choose an emotion as we choose a course of action” [Emphasis mine].

Therein is the crux of the entire argument, the summum bonum (the ultimate goal according to which values and priorities are established in an ethical system) if you will where apathy, empathy, and sympathy are concerned; emotions are as easily selected.  Emotions are as purposefully chosen as the clothes we wear, the food we eat, and every other course of action undertaken.  Emotional selection is always cognitive, and represents a system of beliefs and personal desires, which includes appetites, hopes, expectations of reward, behavioral standard programming, and has as a core an object to emote about.

Girls ListeningConsider the announcement that someone’s cat has died.  What does society say one should do in this situation; take visual cues and match the emotions of the person whose cat died to the environmental situation, and respond in a similar manner.  Feel sad the cat died; why it was not your cat that died.  What if the owner is feeling relief because the cat had suffered from health or physical defects; do we still emote sadness?  What if the owner inherited the cat and is relieved they never have to clean the cat box again, step in wet hairballs, or take as much allergy medicine; do we emote sadness when the owner emotes joy?  Thus, one can more easily see, and understand that emotions are a choice, and empathy and sympathy are emotional traps.

Carrying the dead cat analogy one step further, what if the owner is only reporting their cat died to gain attention?  Emotional responses from others in the social environment feed the control this person now has over the group.  If the cat owner reporting a cat has died uses the situation to get out of mundane tasks, is this acceptable, warranted, or allowed; if so, the control through emotional responses is complete, and the behavior will repeat.  Hence the danger and deviousness of empathy and sympathy as emotional tools in social settings.  Solomon reports on this topic that the cognitive nature of emotions allows for pride to remain intact.  Thus, we conclude that emotions are formed around beliefs and judgments, just like the atomic particle must have neutrons, protons, and electrons.

By comparing emotional creation to the atomic particle, it is not reducing the human emotion to a mathematical formula, nor does it demean any true emotional response to a situation.  The comparison is simply acknowledging the complex nature and elements that are required when the emotion is selected.

Pride 2Pride, is an interesting element of emotional response and centers around self-elevation and enmity (being actively opposed or hostile to someone). The proud person will say, I am better than someone else and be violently opposed to any influencers who are perceived to threaten the superiority of the person emoting pride.  The proud person will always use emotions as a tool for controlling others, which is one of the most compelling arguments against the current business fad, emotional intelligence.  Pride, with its underlying core of enmity, is the root of the common conception of, and popularity for, emotional intelligence. Real emotional intelligence recognizes the cognitive, judgmental, and social aspects of emotions, and works to control oneself.

My best friend has no appreciation for jokes, puns, wordplay, etc.; in fact, my best friend has such an interesting sense of humor, one can often ask why they laughed and receive a logical and cognitively reasoned response.  Yet, my best friend has never been called heartless, unemotional, or the reverse emotional, apathetic, empathetic, or sympathetic.  People interact with my friend and always leave knowing they were listened to, cared for, and appreciated for the good they perform in the world.  My friend has spoken with governors and politicians, homeless people, the sick and afflicted, the whole and happy, and all are treated equally.  How does my friend do this; buy not taking the easy road of emotional connection, but forming a truer relationship through logic, as a cognitive choice.

CourageConsider the anger people chose over the death of Rayshard Brooks earlier this year in Georgia.  Many people chose to be angry and then expressed that anger in burning down a Wendy’s restaurant franchise, rioting, lootings, clogging traffic, stopping commerce, and other actions considered acceptable expressions of anger by the media who reported the events.

In no specific order, the following must be recognized in the Rayshard Brooks event.  First, the expressions of anger were chosen and were considered acceptable by a third party in a social environment.  Second, the actions (visible signs of anger) were an outward display of an inner emotion that was also chosen cognitively as a response to a situation (Rayshard Brooks being shot).  Third, the third-party involved, the media, expected to see these types of actions to justify their time in reporting the incident.  By being a vocal third-party, cheerleaders, if you will, the third-party fed the expected response.  This accelerated and expanded the violence and other deprivations, the same as what occurs in any sports contest where fans are invited to watch and participate vicariously through cheering their team on.

The problem with using my friend’s pattern of living, where the same anger could have been communicated but without all the violence, looting, theft, destruction of private property, and a better community would have ensued, is that of control.  The media would not have reported this event because they could not be a vocal and invested third-party feeding the emotional actions and receiving a return on their investment of time and other resources.  Thus, added to the emotional atomic particle analogy, are the elements of social acceptance, social expectation, and a vocal third-party to justify the actions taken in the name of the emotion granting those actions acceptability.

On a smaller, and thus more socially acceptable scale, the same can be witnessed every day, where the justification for emotional responses, is granted by a third-party expressing sympathy or empathy for those emoting.  Leading to a question, what does the third-party gain from justifying another person’s emotional responses; the power to control.  The emoting person will return to the third-party for justification after each emotional outburst for approval until the third-party deems the actions are no longer acceptable at that given period.

Emotional OutburstFurther emotional outbursts and increased levels of emotional criminology might occur later.  Still, at the moment, those actions have reached the limit of justification and the emoter will choose differently to gain favor and approval from the third-party.  As witnessed in the Missouri riots that spawned the political group “Black Lives Matter (BLM).”  Further, the third-party that controls the justification can turn-on and turn-off those emoting at will, by telling them how they should be responding to a given situation.  The third-party possesses considerable power through the justification of emotional outbursts, the same influence as exerted by an owner or a league over a sports team.

Thus, the paths and dangers of emotion.  Hence one can see the connections between emotions as a choice, a judgment, and a tool.  The sword of emotions is more dangerous to the wielder than to those affected by the emotional outburst, for those wielding emotions are never free of the control-justification cycle, and will remain subservient until they individually cognitively choose different emotions and emotional responses to social situations.

The danger in America right now is that of a vocal and invested third-party, and the justified actions of the minority by the third-party for political ends.  The overabundance of emotions, emotional responses, which include apathy, empathy, and sympathy, and the deprecation of logic and reasoned responses, are doing significant harm to the society called America.  Too much emotion is driving road rage incidents, mobs, destruction of private property, looting, theft, and so much more.  The solution is two-fold, not in any particular order of priority:

  1. Hold the vocal third-party accountable for the actions their minions are taking.
  2. Recognize the cognitive power in choosing emotional responses differently as an individual.

America can heal from these events and be stronger for it, provided we first capture our emotional responses, and eradicate the cheerleading section who grants justification for emotional outbursts not tolerated in children.

Not Passion's Slave - Emotions and ChoiceFor more on the connection between emotion and choice, please read Solomon’s book, “Not Passion’s Slave: Emotions and Choice.”  It is a masterpiece of logic and aids the cognitive person in choosing their emotions more purposefully and intentionally.

© 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/

 

Updated Inspector General Reports – Department of Veterans Affairs: These Actions Must Cease!

I-CareLong have I written about the Department of Veterans Affairs (VA) and the Office of Inspector General (VA-OIG) reports which cross my inbox.  Long have I been utterly disgusted with the waste, fraudulent behavior, and the utter disregard for the patient witnessed in the VA Medical Centers across America.  As a veteran and taxpayer, it is past time to begin to see action to rectify these types of issues.

The VA-OIG conducted an inspection to evaluate concerns related to a Virtual Pharmacy Services (VPS) pharmacist’s discontinuation of antidepressant medication for a patient of the Minneapolis VA Health Care System, which resulted in the patient not having prescribed antidepressant medication for approximately six weeks before dying by suicide.  The VA-OIG found that the pharmacist never notified the psychologist, never checked the patient’s record, simply discontinued the medication.  While the VA-OIG found process and procedure issue, the fact that a medication could be arbitrarily discontinued without a “Red Flag” being raised with the provider and the patient is deeply troubling.  Worse, the quality control processes in the pharmacy did not trigger a problem when a medication was discontinued without a provider order; why?

There is a dead veteran, and a pharmacist who claimed they did not know they could access a patient file; and the excuses do not hold water!  This incident is a tragedy of epic proportion and I must ask, how many more veterans will die because medications are arbitrarily turned off?

ProblemsThe next VA-OIG inspection is a bit of a pretzel, there is another dead veteran by suicide, and processes and procedures were recommended by the VA-OIG to correct some small issues in bariatric surgery patients.  Reading this report, it appears that this veterans’ suicide was not directly connected to preoperative counseling for bariatric surgery which was essentially the scope of the VA-OIG investigation.  If there is a connection between the bariatric surgery and the suicide, it was beyond the VA-OIG investigatory scope.  Hence, the VA might not be at fault for the suicide, but the VA-OIG recommendations indicate more can and should be done in the future to decrease the risks postoperatively.

Let me be clear, room for improvement to decrease risk does not assign or negate blame in this situation.  The death of a veteran through suicide remains a tragedy and the VA can and should be doing more to help reduce veterans committing suicide.  With the convoluted processes and the contradictory bureaucracies inside the VA, much more can be done as an organization to streamline and bring efficiency, transparency, and responsibility to the employees making patient decisions.

Chinese CrisisAnother VA-OIG report does clearly reflect the responsibility and lack of care a patient received at the VA.  The Tennessee Valley Healthcare System in Nashville is responsible for test results still not being properly communicated to the veteran in a timely manner, which delays treatment and care.  Fall 2018, a patient went undiagnosed and untreated for pancreatic cancer due to failures in communicating test results, collaborating with the primary care providers, and for the electronic health records not containing a system of alerting providers that an adverse test result occurred.  Hence, this patient’s problems have three root causes:

  1. Failure to notify the patient.
  2. Failure to collaborate between different hospital units for patient care and safety.
  3. Failure of the electronic health records programming to include alerts.

From personal experience, I must wonder if any patient notification would have made a difference.  The patient notifications are simply the results, not definitions, no descriptions, just ranges, and results.  Hence, the patient notification process must include clarity of the results so non-medical people can understand what was found and the implications.

While I applaud the VA-OIG for insisting that an internal review is conducted and problems rectified, I have significant doubts that change will occur.  It appears that unless the VA-OIG is following up on their recommendations; which is outside the VA-OIG’s authority, the change will not occur.  A truly unfortunate series of events occurred in this patient’s life and the bureaucracy of the VA will prevent anyone from being held accountable for the failures, nor will change occur to protect another veteran.

The W.G. (Bill) Hefner VA Medical Center in Salisbury, North Carolina, was recently inspected for concerns regarding anesthesia provider’s practice.  While no issues were found under the VA-OIG scope regarding the provider’s practices, other issues were discovered.  The problems found were all administrative in nature and included the usual training, timely record keeping, following the policies established by VHA, etc.  Juran’s Rule states that “When there is a problem, 90% of the time the problem lies with policies and procedures, not people.”  How, and when, a person does their job is more often the root of the problem and is evidenced again with this VA-OIG investigation report.  The fact that this problem continues at all VA Medical Centers (VAMC) across America is indicative of a systematic issue in poor organizational design, then in the individual employee.  The VA must address these organizational issues that breed complacency in employee adherence!

LinkedIn VA ImageWith confirmed cases of nepotism still occurring in the VA, this time in Miami.  With continued issues regarding ethics violations and the proper use of time and materials for teleworking employees.  With the continued employee obstruction witnessed in so many cases of records not being readily available to VA-OIG inspectors.  The VA desperately needs to have a deep cleaning and reorganization.  Why has the VA not adopted ISO-9001 for Hospitals?  Why hasn’t the VA adopted ISO-9001 for the VBA or National Cemetery as a coherent process for organizational change and improvement?

Consider that there remains a dearth of written processes, procedures, and policies in the VA.  So much so that more than one VA Hospital operates on “Gentlemen’s Agreements” between departments, instead of official policy statements and procedural plans.  This lack of written policies and procedures is the excuse and the general recommendation of so many VA-OIG inspection reports that I am shocked Congress has not begun asking about this single issue.  The first rule I learned as an EMT was, “If it is not written down, it never happened.”  I was told this is the first rule of medicine; yet, somehow the VA can escape without writing down how to perform work.  Doesn’t that seem strange to anyone else?

Where the lack of written procedures is most noticeable, is at the Veterans Benefits Administration (VBA), where the quality control people missed 35% of the errors routinely, never checked each other’s work, never learned lessons to improve performance, and were not properly supervised.  Yet, training, communication, and written procedures are routinely used as excuses, and corrective action is outside the VA-OIG investigatory scope.  So, while the problems are being identified, the leaders are refusing to do their jobs!  From the VA-OIG report comes the following details:

“The VA-OIG estimated that during the review period, regional office managers inappropriately overturned errors in 430 of 870 quality reviews (about 50 percent) where claims processors requested a reconsideration from a quality review specialist- identified errors. The VBA has not established adequate oversight or accountability to ensure the timeliness of error corrections. The OIG estimated that during the review period 2,000 of 4,400 identified errors (45 percent) were not corrected in a timely manner and 810 of 4,400 identified errors (18 percent) were not corrected at all.” [Emphasis Mine]

Again, I ask, where are the written procedures that form the standards of work which are used to hold employees accountable?  With an 18% error rate never being addressed by quality control, this means that veterans are being underpaid or overpaid for their benefits, and the VBA does not care that these issues are killing veterans.

Survived the VAPersonally, I experienced a VA overpayment that took more than 3-years to payoff.  Three years where my benefits were docked for an administrative mistake that was not found until the next decision was made on my claim several years after the original mistake was made.  What is worse, the mistake I paid for, was not a mistake at all, and the funds were later returned as another quality person found the error and corrected the documents accordingly, but the discovery took another VBA claim decision to catch, from beginning to end this issue of overpayment took three different decisions by the VBA and more than 8 calendar years from beginning to end.

Every single taxpayer in America has a personal stake in seeing the VBA do their jobs timely, efficiently, and correctly.  Every single veteran in America has a vested interest in seeing the VBA perform their roles with fewer rates of error than those reported by the VA-OIG.  Every elected official in America benefits in some way from the decisions of the VBA and should be able to demand higher quality decisions, better performance, and more transparency from the VBA.  Consider, if the problems of performance are this bad for a spot check analysis by the VA-OIG, how bad are the real numbers?

The VBA was also investigated for improper payments to schools through the Vocational Rehabilitation and Employment Program (VR&E) to the tune of $554,998.  Most of the errors were in transcribing numbers and the electronic program did not raise any alerts or attempt to rectify the problems, and no quality control system is in place to protect against human error.  The VA-OIG investigatory scope included 1.8 million payment transactions from 01 Jan 2014 to 30 Dec 2019.  While this is a much better error rate; the fact that the technology and the work processes were not catching these errors timelier, which means more billing issues, more wasted resources, and more problems for the VA, the VBA, the VR&E program, the taxpayer, the colleges and universities, and the impact goes on and on.

The VBA was also recently inspected for failing to accurately decide service-connected heart diseases.  The root cause was the questionnaire developed to ascertain what and when regarding the heart diseases experienced.  Six months, 01 Nov 2018 through 30 Apr 2019, were selected and 12% of the claims were improperly decided which totals $5.6 Million in improper payments where a veteran either received too much or too little for their claim.  Necessitating repayments or backdated payments once new and material evidence was procured to force the VBA to make a new determination.  Inaccurate decisions on claims involve a lengthy appeals process, expenses for testing, and the veteran is always responsible for the mistakes made on their claim.  Thus, the exasperation of these mistakes on the families, friends, and communities of the veteran involved in a VBA mistake.

When the VA-OIG finds errors made by the VBA the veterans affected are not notified that the VBA made an error in their determinations.  The VBA does not form a task force to evaluate these errors and correct them internally unless money is owed and then the collections department is left to muddle through the decision, not the VBA.  Thus, when veterans ask for transparency in the VBA processes, we are asking for the VBA to own their mistakes, fix the problems they are creating, and correct the errors in a timely fashion.  It should not require new and material evidence to trigger the VBA to make a new determination when the VBA made the original mistake in determining eligibility in the first place!

All because the quality controllers do not have written procedures to measure standards of performance against.  All these errors are due to improper organizational design and old computer systems, which are ready-made excuses for not performing work in a timely and efficient manner.  All because the leadership fails to delegate, monitor, observe, and function.  Why are the leaders missing, because they are all in meetings, all day, every day, and not at their desks!

Military CrestsJust like the labor union provided bumper sticker proclaims, “SAVE the VA!” [Emphasis in original], it is time to “SAVE 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 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/

Revisiting LIC – Know the Paradigm

Tucker Carlson brought up a very important point on 16 Aug 2020 regarding District Attorneys who are refusing to do their jobs and are being bankrolled by rich and powerful people.

https://www.foxnews.com/opinion/tucker-carlson-democrats-media-americas-dying-cities

Low-Intensity Conflict (LIC) is the official name for what happens when individuals or governments hire intermediaries to conduct violent operations, from a position of security.  LIC is a misnomer; those who have become a victim of the barbarous cruelty of those practicing LIC find nothing “Low” about the experience.  The conflict is intense, the actions brutal, and the practitioners remain cunning adversaries using and employing willing dupes to hide the true depths of moral decay inherent in the societal destructions and depravations the practitioners are enacting.  Many confuse LIC in trying to describe the actions of unbridled violence committed by ideologues under the banner of terrorism.  The US Military Joint Chiefs of Staff define LIC as:

“A limited political-military struggle to achieve political, social, economic, or psychological objectives. It is often protracted and ranges from diplomatic, economic, and psychological pressures through terrorism and insurgency. Low-intensity conflict is generally confined to a geographic area and is often characterized by constraints on the weaponry, tactics, and levels of violence (Tinder 1990).”

Some will proclaim loudly, mostly due to affiliation with or money donated from deep-pocketed entities, that LIC is only limited to those more commonly perceived as terrorists, i.e., car bombers, hijackers, etc.; however, paid rioters, looters, and those termed by the media as “violent protesters,” are practicing LIC.

Since May 2020, America, and the world has seen explosive violence hardly ever witnessed previously without a global war as a backdrop.  Those unhinged aspects of society who are always upset with something and ready to destroy others have been bankrolled by deep-pocketed entities charges reduced or dropped by District Attorneys who have relationships with deep-pocketed entities, and then we have organizations like Black Lives Matter and ANTIFA, among many others.

LICUp until May 2020, the following aspect of LIC was generally accepted:

“Low-intensity conflict is generally confined to a geographic area and is often characterized by constraints on the weaponry, tactics, and levels of violence (Tinder, 1990).”

Except, this is no longer the case, as entitled entities who are hellbent on destroying their societies have crossed international boundaries, establishing branches in foreign countries, and sharing the wealth generated in one nation to support the anarchy in other nations.  If you do not believe this is true, look to the BLM expansion into Europe as a perfect example of LIC spreading through a branded organization with monetary influence.

BLM has received donations totaling billions of dollars, based upon the media reports of large companies making donations, and the total refusal of BLM to forthrightly declare where the money is going and why.  ANTIFA has been investigated, or are still being investigated, for ties to ISIS.  The money trail paying for violence, or helping the perpetrators to avoid justice, is all LIC.  Somewhere, there is a party who is enjoying the violence, mayhem, and criminal actions immensely that considers themselves above prosecution, beyond political and moral rules and restraints, and these entities need to be held accountable.

A misnomer in LIC is that only nation-states can participate as parties in LIC.  While many nations do participate in LIC to their neighbors’ demise; the power of money to purchase intermediaries to break the law is not new in history.  The following resource remains imperative to understand what is being observed and the connections to LIC:

https://forwardobserver.com/breaking-down-the-conflict-of-low-intensity-conflict/

It cannot be stressed enough, there ARE entities inside America that will use LIC as a means of distracting people to achieve political aims, social change, or simply to cause chaos and destruction.  Knowing the enemy is critical to stopping the enemy!

LIC 2Reference:

Tinder, A. J. L. (. (1990). Low-intensity conflict. Informally published manuscript, Air War College – Air University, Maxwell Air Force Base, Alabama. Retrieved from http://oai.dtic.mil/oai/oai?verb=getRecord&metadataPrefix=html&identifier=ADA241060

 

© 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/

Democracy vs. Republic – American Governance

Please note: A republican method of governance does not mean everyone belongs to and votes the “Republican Party” ticket.  Nor, does the democratic governance method mean everyone adhering belongs to the “Democratic Party” ticket.  The political party is not the style of governance, and this is the first distinction that must be realized.  No political party deserves your support, unless they espouse, and live, what you want them to espouse and live.  America has had good and poor elected officials from both major political parties.  America has even changed major political parties; and this is a good thing!

The Duty of AmericansToo often people are confusing democracy, democratic governance, and the American Republic.  Talking heads in the media get this wrong all the time.  Hollywood has never gotten the distinction correct, ever.  But, this ignorance might be by design as Hollywood has always been a breeding ground for disinformation, propaganda, and elitist posturing.  Regardless of the political party, or lack of political party, every American citizen should be able to recognize Democracy from Republican styles of governance.  The following uses real events to help distinguish the line.

A democracy, at its most basic level, can be described and defined by the control of an organization by the majority of its members.  A simple majority is all it takes to gain the high ground and punish the loser.  A simple majority is if 100 people gather in a room, they need 51 to agree to support a single idea.  Democracies are full of simple majorities who then try to proclaim a moral high ground, and then attempt to extrapolate the single simple majority into a system of keeping the simple majority.

A republic begins with the philosophy and doctrine that embraces equality between its members as the ideal in governance.  Recognizing that today’s majority is tomorrow’s minority, rules provide equality between people, and all titles are transitory.  A republic is messy; equality in treatment under the law allows for every person to have the same opportunity because their inalienable rights have provided them with eternal potential to become anything they desire.  This is especially true when a person desires through their actions, attitudes, and behaviors, which is not desired by the rest of the society, provided the individual does not break the law.  However, laws are not changed to outlaw behaviors, curb ideas, or infringe upon inalienable rights as laid out and codified in the Bill of Rights.

Lady JusticeFor example, The Department of Veterans Affairs (VA) – Office of Inspector General (VA-OIG), recently sent a report regarding an investigation of Peter Shelby, the previous VA Assistant Secretary for Human Resources and Administration (HR&A), who steered a $5 million contract for the benefit of individuals with whom he had a personal relationship.  This is a prime example of democracy in action.  The person in charge had to pay for the simple majority that kept him in power.  Consider the following direct consequences of Mr. Shelby’s actions.

“The contract … included talent assessment services for evaluating whether to hire or promote candidates. When the contract concluded in August 2019, it became evident that VA had purchased services far in excess of what it could use. VA used only 232 of the 17,000 one-year training licenses it purchased for $3.8 million and VA received no value whatsoever for the talent assessment services because required privacy and security certifications were not obtained.”

Mr. Shelby was allowed to resign when he discovered he was about to be fired from Government service.  Thus, he keeps all his retirement, all his Federal benefits, and the money gained from his ill-gotten ventures.  In many countries around the world, these actions are considered, “Realpolitik.”  Realpolitik is politics or diplomacy based primarily on considerations of given circumstances and factors, rather than explicit ideological notions or moral and ethical premises.  In America, Mr. Shelby’s actions are illegal and should have been punished accordingly.

Government Largess 3The American Public has witnessed the same political gamesmanship (realpolitik) in the US House of Representatives, the Senate, and the Presidency, for a long time.  All because, the line between a Republic and a Democracy has been intentionally blurred by those in power, to stay in power.  Never does realpolitik benefit the rule of law, or provide equality as a basic and fundamental position of governance.  Bringing into the conversation the critical quality of genetic behavior and the exponential growth of behavior from one generation to the next.  If Mr. Shelby’s actions can be traced upwards through the behavior of elected officials; how many more unethical behaviors are hiding inside the government workforce waiting for their opportunity to practice realpolitik at the expense of the veterans, taxpayers, and citizenry of America?

Genetic behavioral growth is witnessed when a congressional member is allowed to bend an ethical rule in the name of politics so the simple majority can be sustained.  The next generations are the governors and state legislatures who then replicate and advance that unethical behavior to one that is blatantly illegal, but not “really bad.”  Extramarital affairs, drug use or abuse, alcohol abuse, spouse abuse, homosexuality, etc., are all not “really bad,” laws that are regularly shattered and overlooked to maintain the simple majority.  This then leads employees of governments to act in a looser and more illegal or unethical manner, stealing the public money, misusing government tools and supplies, or in the case of Peter Shelby, forming a relationship and then steering a $5 Million-dollar contract to the entity that most benefits him.

Behavior-ChangeIn a republic, those in power recognize the genetic nature of their behavior, understand that any lapses in good judgment are dangerous, and work to live in a manner that first allows for equality among all.  Even if they must tell another person no.  Consider how much corruption is in Washington, D.C., and every state capital in America, all because the simple majority has lured good people into acting against their principles, against the Republican form of American governance, and against the law established and maintained by the people, for the people, and of the people.  The simple majority will always, to maintain power, refuse to say no, set boundaries, and live by rules and laws.  The republican form of government lives by nothing else but the rules and the laws because equality only occurs under the rule of law.

Notice something important, the first rule of realpolitik is to disconnect the equality of everyone for the power of ruling.  Just as in the book “1984” we see some are more equal than others; which is an extension of democracy.  Then, realpolitik disconnects explicit notions of morality and ethics from actions and behaviors.  Thus, equality is the first casualty in the hostile takeover of democracy.

Consider labor unions for a moment.  Disney produced the movie, “Invincible,” or the story of Vince Papale and the NFL Eagles.  In the movie, there is a union striking, and one sign is made clear, “Striking is DEMOCRACY IN ACTION” [emphasis in original].  The truth in this lie is that strikes are selfish, and represents democracy perfectly.  But, the strike is not democracy in action, the labor union is democracy in action as a legal “pyramid scheme.”  The strike of a labor union, along with all the other work slowdowns, bureaucracies, and other silly games played to thwart republic governance are but tools of democratic leaders to exercise their power.

Religious ThoughtThe labor union spouts a lot of good democratic styled speeches; but acts like thugs, for the benefit of the elected few, at the cost of the dues-paying members.  Proving that democracy is the last thing a labor union wants as the labor union remains a Marxist method of governance.  Take any labor union, anywhere in the world, and you will find the elected officials living large on the backs, sweat, and labor of the dues-paying members.  The fewest of the few long-term dues-paying members will be provided benefits and a lifestyle to be desired, but never obtained, even though the dues have been paid, the labor performed, and the sacrifices made.  The Wall Street Journal has covered the loss of benefits paid for through dues payments, and while the Wall Street Journal does it’s best to keep the union out of the picture, it is not the company’s filing lawsuits, but the unions.

Always, the same principle determines the separation between democracy and republican governance, equality under the law.  The solution is not found in more government programs to “level the playing field,” which is a democratic principle that has never worked!  The solution is found in less government.  Equality under the law is not found in government force; but, in less government potential to exercise that force.  In the 1980s President Reagan was heralded for his nationalizing of the air traffic controllers; thus, ending a strike of the national air traffic controllers.  But, the air traffic controllers still have the same inequalities, same problems, and the same issues as experienced under the air traffic control unions.  Nothing changed fundamentally, and this overreach of government, “for public safety,” has kept the air traffic controller in bondage.  Sure, the cage is nicer, but the cage is still a cage; only now, there is no possible way of escaping the cage.  The same is true of railroad workers, teachers, and so many other employees kept under a labor union’s thumb, or government mandate.

In a democracy, it is perfectly acceptable to maintain the simple majority through nefarious means and ends.  Whereas in a republic, the equality that keeps everyone equally refuses the nefarious types every society produces from having a purchase hold to establish themselves.  Consider the violence that has rocked America since May 2020.  Consider also, all the violence that has shocked and dismayed America since the Watts Riots in 1965.  The Watts Riots are a perfect template reflecting the problems of democracy.

The media, and many people in government including most of the judicial branch, allowed personal anger over issues to become a violent outpouring, where the victim was the community and not the actual target of the violence.  People acted in a selfish manner, with a total lack of self-control, and the community of Watts burned to the ground.  The land is barren, dreams destroyed and lives ruined.  Since the Watts Riots, the community has reached out for more democratic solutions, as if this was not the reason the Watts Riots happened in the first place.  Fast forward from 1965, and every riot since has been glorified for their anger levels, because this helps feed the democratic solutions, keeping people unequal, refusing people their eternal potential, and denying inalienable rights to maintain power and authority.

America, we need to stop the lies that democracy is the “American Way.”  Superman was correct, “Truth and Justice” are the American Way, which is the Republican manner of governance.  America was established upon the fundamental principle that ALL are first equal under the law.  Sure, we have not always lived up to the ideal; but, we are human.  Our humanness is allowing us to falter, not fail.  We fail the great American Republic every time we allow a democratic solution that forces people onto unequal terms.  We stumble, we fall, when we forget that equality is precious and considering all to have the same equality means allowing people to suffer consequences of attitudes and behaviors.

President AdamsWhen one person can be supported in their immorality because of their money (Jackson, Kennedy, Epstein, Clinton, Weinstein, etc.) when others are punished for the same crimes (pedophiles, murderers, thieves, rapists, etc.) we have a democracy.  When all, regardless of money, titles, political power, etc. are held to the same laws and legal standards the great American Republic survives and gains strength.  To rebuild the American Republic, we must first cleanse the inward vessel, removing from public office all those who refuse the blessings and work of a republic for the ease and captivity of a democracy.

© 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/

Moving Past Active Listening to Facilitate Communication: Shifting the Paradigm

GearsIn several previous professional positions, especially those in call centers, there has been considerable time spent training people to actively listen.  The problem; active listening can be faked, and fake active listening is as useful as a shower without soap or shampoo.  You might get wet, but you do not feel clean.

Listening has four distinct levels, these are:

  • Inactive listening – Hearing words, seeing written communication, zero impact mentally. Mostly because your internal voices drown out the possibility for communication.
  • Selective listening – Hearing only that which confirms your own voices, opinions, and biases. While others are speaking, you are already forming your response.
  • Active listening – Show the other person you are paying attention, engage with meaning in a reply. Focused upon removing barriers to get your point across.
  • Reflective listening – Paying attention to intent and content, reducing emotion, two-direction as both parties are engaged in achieving mutual understanding.

Tools for listening effectively, which for all intents and purposes, means listening reflectively, requires several tools, along with considerable experience in using these tools.  Customer service focus – not sales in disguise, not having a hidden agenda, and not covertly looking for opportunities to turn the conversation back to you.  The attitude of service – is all about what your intention is after listening.  Sales are all about attitude and winning over someone else; however, how many sales require first being able to reflectively listen; every single one.  Desire – desire determines your choices, your choices form decisions, and decisions determine destiny!

ElectionConsider the press conferences at the White House.  A room is full of people who would claim they are professional listeners, who then report what is being said.  Yet, how many times do you see questions asked with an agenda, personal opinions warping what is said into what they desired to hear, and then reporting what they erroneously heard to satisfy their desires politically; every single time.  Hence, the problems with active listening and how active listening can be faked.  Desire and attitude of service are not being applied to improve customer service focus.

Communication occurs in two different modalities, verbal and non-verbal.  Good communicators adapt their message to the audience.  Adapting the message requires first a choice, determining who the primary and secondary audience is, then focus the message onto the primary audience.  Next, adaptation requires prior planning, which includes mental preparation, practice, and channels for feedback.  Finally, adaptation requires listening to achieve mutual understanding, careful observation, asking questions designed to lead to mutual understanding, and clarifying what is being said to achieve mutual understanding.

Too often, those labeled as “good communicators” cannot listen reflectively.  They have never learned how to use the tools of desire and attitude of service, in a manner that builds customer service focus into reflectively listening.

Leadership CartoonConsider two people the media has proclaimed as great communicators, Presidents Reagan (R) and Obama (D).  President Reagan was listened reflectively, asked good questions, listened to the answers, asked more questions, and then listened some more.  In listening and asking questions, President Reagan built people (customer service focus) and was respected by enemies and friends for his ability to communicate (personal desire determined destiny).  President Obama has been labeled by the media as a good communicator; but by all accounts, he never listened, his questions showed he desired to be heard, and his focus was all on him as the smartest person in the room.  Desire builds an attitude of service, which then forms the customer service focus, which then reflects a desire to reflectively listen and achieve mutual understanding with those being communicated with.

One of the most despicable problems in customer service today is a theme established by Stephen Covey, “Most people do not listen with the intent to understand; they listen with the intent to reply.”  On a recent issue, a letter was sent to Senator Martha McSally (D) of Arizona, the response has formed the epitome for not listening in written communication as the response had nothing of the original issue even discussed.  The response was a form letter, on a different topic, and lacked any response that the sender had been heard; but, the letter advertised Sen. Martha McSally and her commitment to listening to her constituents.  But, you might say, a Senator is too busy to respond to every communication delivered, a few other examples of both verbal and non-verbal communication failures.

  • Two lieutenants, representing the Department of Veterans Affairs, Federal Police Service, stationed at the Phoenix VA Hospital. Engage a person not wearing a mask.  Body language clearly states they are the authority and will broker no resistance.  The officers spend 45-minutes haranguing the patient before cuffing and frog-marching the patient to a holding cell, where the patient who was seeking services in the emergency room, waits for an additional 60-minutes before being forced off Federal Property.  The patient informed the officers multiple times of their pre-existing condition and inability to physically wear a mask.  The hospital mask policy allowed for a face shield to be worn instead of a mask, and after the patient put the face shield on, the officers continued to verbally engage without listening, until the foregone conclusion of arresting the patient could be justified.  The patient was fined $360.00 (USD) for “disorderly conduct” by refusing to wear a mask.
  • Calling a major cellular phone provider (AT&T) with questions about the price plan. The representative answered every question but needed to make a sale, and their focus was on making that sale, not on assisting the customer.  Not the agent’s fault, the policy of the call center is to up-sale on every call.  If the agent does not up-sale, the call is automatically downgraded in quality assurance and the agent gets in trouble.  Hence policy dictates that the customer not be listened too reflectively as the sale must come before the customer.
  • Hotel check-in, online registration was made specifically for a particular sized bed, but due to late check-in, the customer is not provided what was asked for, and the attitude of the clerk is one of disgust at being bothered. Verbal and nonverbal cues are sending messages that the customer is the problem and is interrupting the life of the clerk.
  • A patient receives a call to make an urgent appointment with a VA medical provider in general surgery. The medical provider has demanded the patient be seen in the clinic, thus negating a phone or video styled appointment.  The patient’s record clearly states the patient has trouble complying with mandatory masking for patients seen in the clinic.  The provider arrives 20+ minutes late to the appointment, and because the patient is not wearing a mask immediately refuses to see the patient, wasting 90-minutes of the patient’s day.  The provider gets off in 10-minutes, and seeing the patient will make the provider late getting off.  Was the mask really the problem; not likely.

Social Justice Warrior 2Not listening is probably the largest social problem in the world today.  Everywhere fake active listening is observed, along with copious amounts of observable inactive, selective, and active refusals to listen.  Some of the problems in improving listening are policies and procedures that do not allow for individual adaptation or situational understanding.  However, too often, the individual choices to grab power, exercise authority, and pass along inconvenience are the real problems in not listening.  Harvey Mackay is reported to have said, “Easy listening is a style of music, not an attribute of communication.”  Proving again that listening is a choice, a personal choice, borne from desire, bred on attitude and reflected in verbal and non-verbal patterns of communication.

The following are some launch points for improving listening in society:

  1. Understand your desire.  Know that your desire choices are determining your destiny.  If your destiny is not one, you appreciate, return to the desire and make different choices.
  2. Practice mental preparation, based upon previous situations, to make different choices. Listening is a voyage of discovery to reach a mutual understanding, but mental preparation is key to safely reach the destination.  Prepare, use a mirror, practice until what currently feels alien becomes familiar.
  3. Reduce emotion. The principle of empathy and sympathy are destroying listening and only reflect the internal voices.  The volume of internal voices is silencing the ability to reflectively listen, necessitating the need to fake actively listening for employment’s sake.
  4. Listen as you would have others listen to you. This is an adaptation of the “Golden Rule” and remains applicable as a personal choice.  How you choose to listen will determine your destiny.
  5. Listening remains the number one tool you control and has application to written communication and verbal communication channels. Body language is a non-verbal communication channel that can be heard as well as seen.  How are you communicating non-verbally, which is interfering with your written and verbal communication attempts?

Listening is a choice.  Listening is hard.  Yet, many people have pointed out that we have two ears and one mouth so we can listen twice as often as we speak.  Choose to reflectively listen, choose to reach a mutual understanding, watch your destiny change.

© 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/