Sexual Harassment – DNC-Consulting

When is Enough… ENOUGH? – More Chronicles from the VA

Honest question. I surpassed my ultimate threshold in waiting for the VA to improve in 2010 and stopped accepting the excuses, the platitudes, and the whiny discourse from the VA. Elected officials charged with scrutinizing the US Government, when has patience been surpassed, and you will cease allowing this nefarious Kabuki? The veterans are waiting, the taxpayers are fed up, and you need to make a decision and act.

Consider the following investigation by the Department of Veterans Affairs (VA) – Office of Inspector General (VA-OIG). The scenario:

“The VA Office of Inspector General (VA-OIG) conducted an audit to determine how effectively the Veterans Health Administration (VHA) billed private insurers. [Billing private insurance is a piece of legislation that the VA has haphazardly followed. The VA remains the first party payer and is authorized under 38 USC 1729 to bill and collect reasonable charges for nonservice-connected care where such veterans have other private health insurance.] Prior OIG investigations have shown that VHA has missed opportunities to recover funds that could be used to help finance care for other veterans. VHA’s Office of Community Care (OCC) manages community care programs and bills private insurers when needed. OCC must submit reimbursement claims before insurers’ deadlines are reached, or they may be denied.”

The legislature passed laws demanding action, and the result was:

- - OCC did not establish an effective process to ensure staff billed veterans’ private health insurers as required
  - OCC did not collect an estimated $217.5 million that should have been recovered, a figure that could grow to $805.2 million by September 30, 2022
  - OCC’s billing and revenue collection process also was not synchronized with insurers’ filing deadlines, and claims information was not always available for billing
  - Pending workload volume and staff shortages hindered effective billing
  - OCC was broadly aware of challenges to its process to bill and collect revenue from private insurers; its responses were insufficient to correct these issues.

Hundreds of millions of dollars are sitting on the table, and the VHA – OCC still cannot properly follow the law. Worse, they are slower than molasses running uphill in Michigan in January to pay community providers, inventing hoops and red tape nonstop for providers, which increases the cost of healthcare. This is not the first VA-OIG investigation on this issue in 2022, let alone since 2000; with the same findings, the same recommendations are issued, and nothing improves. Thus, I have two questions:

When is enough ENOUGH?
How does this reflect the VA Administration’s commitment to the vision of the VA?

Consider the following; the VA-OIG regularly conducts comprehensive healthcare inspections of VHA facilities. The findings of these investigations are supposed to spur institutional improvement. Regularly the VA-OIG places the following comments into the reports of these investigations, hoping nobody will ever read the report and find these facts.

“The VA-OIG found deficiencies in identifying sentinel events and conducting institutional disclosures. Additionally, there were repeat findings from the June 2017 comprehensive healthcare inspection related to inter-facility transfers.”

Imagine a private company being inspected by the government for a moment where previous investigation findings were not improved; what would happen? An army of lawyers would descend on the customers looking for those harmed/injured, legions of lawyers would pour through employee records looking for injuries and other potential claims, the government would seize assets and halt production, all this and more. The media would be covering 24/7 news cycles on the slightest allegations of wrongdoing. Elected officials would be hurrying to write legislation and find a media talking head to bloviate to.

What do we hear where the VA is concerned; not even crickets! The VA has played complicit roles in veteran deaths, and still not a peep, word, or even crickets. Remember, these findings occur frequently enough that not finding these remarks is a cause for celebration and is exceedingly rare. Thus, I have two questions:

When is enough ENOUGH?
How does this reflect the VA Administration’s commitment to the vision of the VA?

Other oft findings from comprehensive healthcare inspections include the following:

- - Medical center leaders were generally knowledgeable about selected data used in Strategic Analytics for Improvement and Learning models (SAIL Metrics). – What does “generally knowledgeable” indicate? Why have we accepted general knowledge from those who should have specialized, detailed, and comprehensive knowledge and use this knowledge in daily practice?
  - Outpatient satisfaction survey results were generally higher than VHA averages but revealed opportunities to improve specialty care experiences for female veterans. – Please note beating the VHA average is good but nothing to brag about. Beating the VHA averages is akin to claiming to be the biggest pig in a pig wallow. Sure, you’re big, but you are still covered in mud!
  - Employee satisfaction survey scores for the medical center were lower than VHA averages. – Not a surprising finding in any way, shape, or form. Employee morale is scathingly low, and it shows in every customer interaction! More comparing pigs by size in a pig wallow, and it’s not like the VA would punish whistleblowers, fire productive people, castigate, denigrate, deride, and treat employees like chattel… Oh, wait, yes, it is!

Interestingly, I receive 3-10 of these monthly investigation reports from the VA-OIG, and too often, they read like someone is cutting/pasting the findings from one report to the next. Thus the conclusions of these findings occur frequently enough that not finding these remarks is a cause for celebration and is exceedingly rare. Therefore, I have two questions:

When is enough ENOUGH?
How does this reflect the VA Administration’s commitment to the vision of the VA?

Let us consider another VA-OIG investigation, which, unfortunately, recurs too frequently where inappropriate conduct is a norm, not an exception. VA facility leaders’ response to inappropriate relationships. Regular readers will know how common it is to find inappropriate relationships and sexual misconduct by VA Employees to other employees, underlings, and veterans. The scenario:

“The VA Office of Inspector General (VA-OIG) conducted a healthcare inspection to evaluate leaders’ response to the knowledge of inappropriate provider-patient relationships. The VA-OIG determined that while facility leaders initially addressed three inappropriate relationships between mental health providers (Providers A, B, and C) and mental health patients (Patients A, B, and C), multiple factors affected the effectiveness of those actions.”

Finding the following:

- - The OIG found that effective facility leader actions to investigate and address the inappropriate relationships of Provider A and Provider B occurred only after an Office of Accountability and Whistleblower Protection complaint.
  - Facility leaders ineffectively addressed Provider C’s inappropriate relationship before Patient C died by overdose.
  - Facility leaders failed to report Providers B and C to their state licensing boards promptly.
  - Failed to report Provider A to the appropriate professional certification board.
  - Facility leaders did not take actions to address the circumstances that contributed to the death of Patient C, who was involved in an inappropriate romantic relationship with Provider C.

Regrettably, the VA-OIG could not determine if an adverse patient event occurred when finding that the inappropriate relationship played a role in a veteran’s suicide by overdose. I understand investigative scope creep, but this is ridiculous. You have a dead veteran in an inappropriate relationship with a provider, and you cannot investigate if this was an adverse event. What type of bureaucratic inertia sponsored this madness?

Some items in this investigative report stand out, beginning with the fact that the facility leaders who refused to take action remain employed by the VA! Knowing about problems and not taking prompt and decisive action is negligence in performing one’s duties. Possessing authority and refusing to implement policies and procedures, ensuring compliance by professionals, defies description and should result in VISN leaders losing their jobs! Unfortunately, these inappropriate relationships are not rare; even if the VA-OIG has not gotten around to investigating the problems, ask the VA employees, and you will find the proof of concept and incredibly high frequencies. Hence, I have two questions:

When is enough ENOUGH?
How does this reflect the VA Administration’s commitment to the vision of the VA?

In the annals of government fraud, waste, and abuse, the following VA-OIG investigation must rank in the top 20 somewhere.

“The VA Office of Inspector General (OIG) initiated this review to evaluate whether purchases of iPads and iPhones for veterans met mission needs while minimizing waste during fiscal year (FY) 2020 and through the first two quarters of FY 2021. In July 2020, Connect Care officials purchased 10,000 iPhones with unlimited prepaid data plans for the homeless veterans enrolled in the HUD-VASH program. However, 8,544 of the 10,000 iPhones remained in storage as of July 2021, as demand for the iPhones was much lower than anticipated. The OIG found that this resulted in an estimated $1.8 million wasted data plan costs. The OIG also identified opportunities for improvement regarding data plans for nearly 81,000 iPads purchased. Because Connected Care did not have strong enough oversight procedures for reducing or eliminating data plan waste, it incurred approximately $571,000 in additional wasted data plan costs.”

When I was offered telehealth, I was responsible for providing the equipment and maintaining an Internet connection. This was made clear by the VHA Administrators before they signed off on allowing me telehealth and reiterated by my providers when they renewed permission. How can the VHA and VA leadership and contracting officials imagine this is acceptable? How many of these devices are still in the hands of veterans? How many have broken, been pawned, or otherwise not survived?

Again, not casting aspersions, merely asking questions, namely the following:

When is enough ENOUGH?
How does this reflect the VA Administration’s commitment to the vision of the VA?

I could weep from the frustration felt in reporting another veteran’s death by suicide, receiving care from mental health providers with the VA, and being investigated by the VA-OIG, where the providers are complicit. The scenario:

“The VA Office of Inspector General (VA-OIG) conducted a healthcare inspection to evaluate VA-OIG-identified concerns related to the assessment and documentation practices of a behavioral health certified registered nurse practitioner (BHNP) and leaders’ completion of BHNPs’ ongoing professional practice evaluations (OPPEs).”

The findings:

- - The BHNP did not perform thorough suicide risk assessments for a patient who died by suicide.
  - Identified multiple deficiencies in a BHNP’s assessment and documentation practices, including the absence of comprehensive suicide risk assessments, failure to complete abnormal involuntary movement and metabolic assessments for patients prescribed particular antipsychotic medication, missing informed consent or a risk-benefit discussion when prescribing off-label medications, failure to resolve rule-out diagnoses, and substantial copy and paste use.
  - Finding adverse clinical outcomes for one of eight patients for whom the BHNP did not document a comprehensive suicide risk assessment, as required by The Joint Commission.
  - Finding the Nurse Manager evaluated BHNPs as satisfactory in the OPPE elements of copy and paste use for the fiscal year 2018 through the first half of the fiscal year 2021 and safety plan completion for high-risk suicide patients for February 2020 through the first half of the fiscal year 2021, without these elements being evaluated.

Is it clear why I am asking about where the limitations of patience are? The supervisor was directly responsible for leading the BHNPs and failed, and while it is not mentioned, we can presume this person remains employed. Failed to train staff, failed to supervise staff, refused to do your job. Yet, you remain employed (probably) and (potentially) were promoted, as this is the regular pattern for VA employees caught but who are politically acceptable or connected. The supervisor is directly connected to a dead veteran, a family is weeping this holiday season, friends are missing, and all I can do is keep asking the politicians:

When is enough ENOUGH?
How does this reflect the VA Administration’s commitment to the vision of the VA?

Do you also feel the weight of responsibility; your tax dollars fund this abuse. Representatives of your government are complicit in adverse patient events, including death, and they refuse to engage, holding government employees accountable and fixing the mess. Veterans signed a check, telling the government we will perform duties and obligations. Why aren’t the veterans honored for their sacrifice and respected by elected officials and government employees, especially at the VA?

America Weeps The VA’s mission statement is “to fulfill President Lincoln’s promise “To care for him who shall have borne the battle, and for his widow, and his orphan” by serving and honoring the men and women who are America’s veterans.” The statement is meant to echo the reverence given to the men and women who serve in the American military with honor. Reflecting that this body (the Department of Veterans Affairs) is tasked with serving them respectfully, similar to how they served their nation. One final question is, “Does killing, abusing, and harming veterans equate to honoring the VA mission statement?”

© Copyright 2022 – 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 images. Quoted materials remain the property of the original author.

Fed UP! – More Detestable Bureaucratism from the VA.

I-Care I hate being lied to! More than I hate being lied to, I detest, with every fiber in my being bureaucrats and the inanity they promulgate to excuse their stupidity and throw a wrench into the works. Today I suffered through yet another call with my VA-appointed primary care provider (PCP). Not an online conference, but a phone call. Who was in the office with the provider and why? How can I guarantee my HIPAA information during a phone call on an unsecured line? How do I know who I am talking to? These concerns and more arise when you receive a phone call to discuss important medical information, and my PCP does not care! My PCP refuses to use the VA’s tools to conduct patient appointments and instead creates workarounds; what an ingenious method for telling lies and spreading falsehoods as bureaucratic inertia; I’m so thrilled!

The PCP continuously claimed all my imaging is “normal” and “unremarkable.” The pain experienced cannot be related, and the sources are questionable. In polite speak, the PCP is trying to tell me it’s all in my head; a previous provider from the VA already used this as an excuse for not performing their job. For more than 10-years, I have been fighting the VAHCS for help in reducing pain and in getting to root causes for the problems experienced. Yet, today’s call was just more of the same BS wrapped in feel-good words, platitudes, and bureaucratic non-answers. Honestly, after the third time the doctor related, the imaging was normal and unremarkable; I lost my cherub-like demeanor! I did not swear until I got off the phone, but I am not anywhere close to a happy patient.

Honest question, does the VAHCS troll medical school for the bottom of the barrel, those people who can barely pass a class, let alone qualify for medical privileges? I need competence, and I get useless lumps. I ask questions, and the snowflakes pop out of the woodwork like ticks on a deer or fleas on a dog. I am thoroughly sick of being treated like a know-nothing inconvenience. The most important person in the VA marketed PACT Team is the patient who will be active, engaged, and informed. The second most important member of the VA Marketed PACT team is the Primary Care Provider. VA 3

Since 2002 I have had a problem in my gastro-intestinal system; since 2010, the pain has been debilitating, and four years ago, I was diagnosed with non-alcoholic fatty liver disease. Today, 22 March 2022, the PCP reviewed the problems area on my electronic health record (EHR), which coincidentally resides at the top of the electronic health record and was mentioned four different times by myself, and noted that non-alcoholic fatty liver disease is not listed. Tell me, how would that make you feel? The PCP ordered today’s call before the recent imaging appointment on my abdomen and pelvis, but the provider, who called me almost 30-minutes late, did not even look up my record before calling. Had not studied the imaging results and formulated a plan of action to move forward, yet as the second most important member of the PACT team, I am supposed to trust this bureaucrat; I think NOT!

Through the miracle of modern technology, I had read and researched the imaging results more than 24 hours before the scheduled appointment to discuss the results. I came prepared, but the provider could not be bothered to prepare for a call they demanded, then had the sheer effrontery to keep repeating that the imaging is “normal” and “unremarkable.” Then the provider has the gall to tell me, repeatedly, that I was yelling, when in fact, she only did not like being spoken to with emphasis and insistence that she do her job! Yes, I called her a bureaucrat and a snowflake, whereupon she threatened to hang up the call, but I disconnected first. I miss those old rotary phones you leased from AT&T, they had heft, and when slammed, they made you feel better about disconnecting a call. PACT_model

From research, it is abundantly clear that pain from hernias can show up or be felt in areas far removed from the hernia site. Constipation is both an indicator and a symptom of hernias. Muscle weakness in the legs, burning sensations, and much more are all indicators of a hernia. Yet, when I asked about all the other pains and problems experienced in my abdomen, I was told the hernia could not be the root cause, and the imaging is “normal and unremarkable,” but the PCP could not answer why these other symptoms are unrelated when asked. Where is the research, seeing as “Dr. Google,” is discouraged; Johns Hopkins and the Mayo Clinic, plus I have access to the medical libraries at the University of Phoenix and Grand Canyon University. With less than five minutes of research, I can locate and read data from reputable sources to form the basis of questions to ask a PCP, which is encouraged of patients by the VA. Yet, the doctor cannot be trusted to provide any intelligent data, do any preparation, or knowledgeably speak to a symptom list; when will the VA answer why their PCP cannot do their job? PACT 1

If only I were the only person experiencing these problems and issues with the VA.

Former VA cardiologist John Giacomini of Atherton, California, pleaded guilty to one count of felony abusive sexual contact. In the fall of 2017, Giacomini repeatedly subjected a subordinate electrophysiologist to unwanted and unwelcome sexual contact, including hugging, kissing, and intimate touching while on VA premises. On 10 November 2017, the victim explicitly told Giacomini she was not interested in a romantic or sexual relationship with him. Nevertheless, Giacomini continued to subject his subordinate to unwanted sexual advances and touching, culminating on 20 December 2017, when Giacomini turned out the lights in an office, pulled the victim out of her chair, and fondled her until a janitor opened the office door and interrupted the encounter. The victim later resigned from her position at the VA, citing Giacomini’s behavior as her principal reason for leaving. Sentencing is scheduled for 12 July 2022.

Will the VA-OIG troll through this former provider’s employment history seek out the other victims, or will this be swept under the rug not to tarnish the VA? Having been an employee of the VA, will anyone, EVER, look at how employment law is abused by the leaders in the VA and correct the problems? This incident should never have occurred, nor should it have taken years of abuse to end this despicable behavior. Yet, what does the VA do, shut both eyes and pretend it does not occur in consequence of the designed culture at the VA.

Why did the victim have to tell another adult that their behavior was unwanted, and quit their job, before the VA took action? Will there be an inquiry from congress? Will any lawyers stand up and demand the VA correct this detestable hole that allows this behavior to promulgate? I am not holding my breath!

Speaking of electronic medical health records, the VA-OIG has issued three separate reports on this topic, and none of them paint the VA with anything that shows competence. In the report titled:

“Medication Management Deficiencies after the New Electronic Health Record Go-Live at the Mann-Grandstaff VAMC in Spokane, Washington.” The following findings were related:

“Deficiencies in medication data migration and management resulted in patients having inaccurate or incomplete medications in their records or made filling prescriptions accurately more difficult—all of which can affect patient care and safety. Areas of concern included:

(1) Data migration
(2) Medication formulary availability
(3) Medication order processing
(4) Provider notification and alerts
(5) Controlled substance tracking
(6) Prescription drug monitoring program documentation
(7) Medication reconciliation
(8) Medication list accuracy.” VA 3

As previously stated, I am not as nice and never politically correct. VA-OIG, please allow me to correct your assertion, “Deficiencies in medication data migration and management resulted in patients having inaccurate or incomplete medications in their records or made filling prescriptions accurately more difficult—all of which DO negatively affect patient care and safety.” Trust is the first casualty in war and in dealing with the VA in ANY form, manner, or method. When you cannot trust your data to remain confidential, the entire electronic medical record system can only be rated as UNACCEPTABLE! The upgrading of the electronic medical records system at the VA is a 10-year, multi-billion-dollar fiasco, and as a taxpayer, I am done paying for this system!

Not to be outdone by the medication side of veteran care experiencing failures, the following VA-OIG report was issued:

“Care Coordination Deficiencies after the New Electronic Health Record Go-Live at the Mann-Grandstaff VA Medical Center in Spokane, Washington.”

“The EHR rollout caused problems in coordinating veterans’ care, ranging from the flags for patients at high risk for suicide not transferring to veterans and their care providers having trouble accessing video appointments and patient portal messaging. Tracking outcomes were sometimes lost, and disappearing laboratory orders also resulted. Although the OIG did not identify associated patient deaths, future deployment of the new EHR without resolving identified deficiencies could increase risks to patient safety.” VA 3

Again, the VA-OIG is practicing political correctness instead of being specific, and upfront, the entire EHR is a disaster, the cost is prohibitive, and any fool should see it is time to pull the plug, cut the losses, and hold the leadership accountable! Yet, what do we see; the EHR is progressing into infinity and beyond at a snail’s pace!

The final nail in the VA’s EHR coffin should be that nobody involved can communicate with the IT helpdesk for the EHR as the IT ticketing system is unreliable! Form the VA-OIG, we find the following:

“Ticket Process Concerns and Underlying Factors after the New Electronic Health Record Go-Live at the Mann-Grandstaff VA Medical Center in Spokane, Washington.”

“The failure to process and respond to VHA staff ticketing requests for help or report concerns resulted in reporting, tracking, and resolving problems. These deficiencies made it difficult for clinicians and administrative staff to serve patients and impeded EHR fixes that can affect future sites. The inspection team also identified five factors contributing to the deficiencies identified in the two companion reports above: usability, training, interoperability, needed fixes, and problem resolution.” VA 3

Imagine for a moment, you are responsible for a multi-billion-dollar IT project, and one of the first issues discovered by the users is the inability to reach out for IT help; how long would you remain employed? Would you ever expect to ever work again if any of these problems were your legacy for leading the IT improvement on a multi-billion-dollar project? As a consultant, I know how fast you would be fired and taken to court for business losses. Why are these leaders exempt? Where are the blue-ribbon panels and committees demanding people be held accountable for this fiasco? EHR-VA-OIG

When the VA-OIG casually mentions that PCPs are untrustworthy and not using the current tools correctly, should the providers be issued new tools; NO! Yet, this is the opposite of what common sense declares. Are you, dear reader, as a taxpayer, fed UP yet? My wife reminds me, “These problems happen in civilian hospitals.” No, in fact, they do not. If data migrated from one patient’s EHR to another patient’s HER, that hospital would be sued and shut down so fast by congress at the federal and state level, all before the media firestorm would have barely begun. If a patient were jeopardized because their provider could not track medications, that patient would sue for malpractice and possibly a class-action lawsuit. If an IT project was occurring in the civilian world, and the users could not contact the IT helpdesk, the project would be overhauled so fast, and people fired, new records would have been set.

Knowledge Check! It is time we end this charade and money pit call the Department of Veterans Affairs, and every other agency of the Federal government bloat! The government should be leading, not lagging, where operational efficiency and fiscal sanity are concerned. I repeat, only for emphasis, are you fed UP yet?

Unconscious Bias – A Fallacy of the Oppressor!

Bobblehead Doll A few years ago, I had the unfortunate privilege of having for a manager a homosexual person. Let me emphasize; I do not care about your personal choices and lifestyle; keep it to yourself and out of the workspace. Hetero- or homosexual, does not matter; it does not belong in the workplace! Back to the manager, as he was openly homosexual, he embraced all the biases claptrap and accused me of being racist and homophobic. quote-mans-inhumanity

Of which, I am neither. When informed that I am neither homophobic nor racist, sexist, genderist, etc., I was told he was observing my unconscious biases and claiming that I was not biased was actually declaring I was heavily biased. He then went so far as to write me up for being biased. At the time, I had not studied the research on biases and could not counter his charges. This manager chose to stand inside personal space for the guys on his team, but not the females, which was sexual harassment, but the business refused to think this was sexual harassment. That this manager continually rubbed himself against the guys on his team was also rejected as sexual harassment. quote-mans-inhumanity-2

I have learned much since this incident, and I want to help those in similar situations understand a few pieces of the language plasticity that goes into the bias arguments. I will be clear that if a heterosexual male rubs against a female, which is considered sexual harassment, then the same is true for a homosexual, regardless of gender. Being uncomfortable with being touched is not an indication of bias, simply an expression of a personal preference.

Unconscious Bias

3-direectional-balance Bog-standard bias is considered as attitudes, behaviors, and actions that are prejudiced in favor or opposition to a person, group, or thing. But, here is the clincher, bias is judged by others as a projection of themselves when they encounter other people, places, or things. If you think you have a handle on the language of biases, an unconscious bias is also called an implicit bias. Implicit bias is described as bias that occurs automatically and unintentionally, that nevertheless affects judgments, decisions, and behaviors, however just to keep you in the dark, implicit biases are also stereotypes. In social identity theory, an implicit bias or implicit stereotype is the pre-reflective attribution of particular qualities by an individual to a social out-group member. Implicit stereotypes are shaped by experience and learned associations between certain qualities and social categories, including race or gender.

Now, if you think you finally have a grasp on biases, stereotypes, and preferences, we add the final straw to the argument. Biases and stereotypes are judged by an observer using their understanding, education, experience, and opinions as a projection upon you and your actions, behaviors, and attitudes as a lens to understand the world around them. Thus, my not saying “Good Morning” to my manager was projecting his own biased thinking and homophobia, declaring my actions are homophobic slurs. In reality, I am not a morning person and generally do not talk to anyone, spouse included, before 0800. Walking in at 0400 to begin a shift in a call center meant my cherub-like demeanor had not woken up yet, and silence was the only policy.

Bias Self-Auditing

In my email box, I have an email that includes a self-audit of bias for managers. Before continuing, consider what you know about bias. Bias is the thoughts, feelings, ideas, and visions of another person, project upon you and your actions, attitudes, and behaviors, so the person projecting can understand the world. I cleaned up the obvious grammatical errors, not that this improved the material very much.

How and to whom do you delegate work?

- - - - By giving specific tasks to one team member, am I depriving another team member of a growth opportunity?
        
        Am I giving the same level of detail, and therefore equally setting each team member up for success when I assign projects?

End goal: Ensuring that everyone has an equal chance to take on challenging and meaningful projects

How do you give feedback to different direct reports?

- - - - Am I delivering feedback casually to some team members and formally to others?
        
        Do I soften critiques for some team members more than others?

End goal: Making sure you’re delivering feedback equitably.

Any generalizations you make about team members.

- - - - What kind of assumptions am I making about team members based on age, ethnic background, race, gender, sexual orientation, religion, appearance, or anything else?
        
        Do my assumptions impact how I feel about their capability and competency?

End goal: Minimizing the perpetuation of stereotypes while practicing and displaying empathy.

Who do you praise publicly, and who do not praise publicly?

- - - - Is there a personal motivation behind team members I praise publicly and those for whom I withhold praise?
        
        Do I limit the exposure of my compliments for some team members and show my appreciation more widely for others?

End goal: Ensuring that you’re sharing accolades fairly.

How and with whom do you exchange casual banter?

- - - - Do I have friendly conversations or share memes with some teammates more than others? How might that affect workplace alliances?
        
        Do some teammates feel alienated or marginalized by witnessing my apparent affinity for other teammates?

End goal: Avoiding outsized allegiances with people based on your shared perspective to the detriment of developing relationships with others with different viewpoints.

Who do you go to for advice?

- - - - Do I go to the same people time and time again for mentorship? Do they look like me?
        
        Are there people to whom I could go for advice and a more expansive perspective?

End goal: Avoid making decisions based only on the feedback shared in an echo chamber.

Consider these statements with me for a moment as part of a discussion on biases. Feel free to leave your comments in the space provided below this article. When I need advice, my manager is younger than I am, but has years of experience in the company. His boss is older than I am by a little bit. They both look like me. Does this automatically mean that I must sacrifice talents, skills, abilities, and tenure because the information comes from someone who looks like I do? No, logic screams. But the emotional immaturity of those casting biased aspersion will claim yes. Anton Ego

When I first arrived on my ship USS Barry (DDG 52), my second-class petty officers were two white males, one black male, and one black female. For competence, I went to the black female as she displayed the most leadership—the two white males were involved in their own relationships and were rarely available to answer questions. The black male did not possess the maturity to answer questions. The first-class petty officers were three white males, two of whom embodied immaturity, and our chief… well, let’s not speak ill of the dead. If I acted as these bias audits claim, my Navy career would have been disastrous, for I would have rejected competency and maturity for race, gender, and incompetence.

Suggestions, Ideas, and Thoughts

Stop seeing race, gender, nationality, and other lines of separation. These are distractions cast upon everyone by foul oppressors who see these lines of separation and project their inadequacies upon everyone else. It is perfectly acceptable not to have biases and claim you have no preferences. I do not care about your gender, race, color, creed, religion, handicap status, or anything else. I care only about your competency, and if I can help you, or you can help me increase competency, let’s work together!

Believe that you are a good person! I know those projecting their inadequacies and claiming you have biases are profoundly pernicious in their approaches. But, when you have confidence that you are doing the best you can, you can rest easy when these pernicious oppressors begin to attempt to humiliate you. In the movie “The Sound of Music,” there is a song called “I Have Confidence.” When you need reminding of your goodness, play this song, and sing along at the top of your lungs! I promise you will feel better!

When you treat everyone as you desire to be treated, without fear and with confidence, you will always have loyal people at your back to support you. If you live by implicit bias and fear, the whole world will never trust you, and you will not have confidence in yourself. Those who oppress want you miserable; deny them that opportunity! Knowledge Check!

Living without biases is possible, is easy, but is sometimes not very convenient. But, as Mr. Miagi said in the original “Karate Kid,” “Man who walks in street, gets squished like grape.” Dr. Seuss is right, “Be the best you, you can be.” Stop allowing the oppressors into your mind; they are not worth your time.

Micro-Networks, Macro-Networks, and Polarization: Understanding Begets Opportunities

Corporate political infighting is one of the most fundamental challenges to organizational design. Incorporating disparate micro-hierarchies into a cohesive whole is akin to herding cats in a room full of rocking chairs. Unfortunately, micro-networks and polarization is making the job harder over time.

Defining micro-networks, macro-networks, and polarization opens the doors for opportunities. Still, a leader will have to choose to walk through those doors to discover the opportunity. Experience teaches that micro-networks exist in every business, industry, and occupation. Thus, what is applicable to call centers is directly translatable to every other business venture.

Micro-networks are the epitome of “Old Boy Networks,” the social clubs, golfing buddies, and intimate friend relationships of the modern business culture. Micro-networks often cross departments, teams, and internal work structures. Micro-networks include diverse people in roles of power, understood through work role, not specifically a job title, and often exists long after people have left an organization, a group, a specific team, etc.

Micro-networks always exhibit an unwillingness to change. The micro-network is a hybrid hierarchy established as a virus to the standard organizational order. By possessing a separate system, confusion will abound, problems arise, and the micro-network will be the root cause, even if the analysis points elsewhere. Micro-networks are the lazy manager’s approach to problems, using the same people with the same connections to accomplish work in the same manner.

The problem of micro-networks is prevalent, especially in call centers; many times, the call center leadership promotes micro-networking to accomplish the tasks and goals of the organization. People will always form teams of like-minded individuals geared towards protecting themselves, which leads to entrenched bureaucracies and hierarchies, which sums the problems and defines the micro-network perfectly.

For example, a department in a call center for a globe-spanning organization is not run by the team leaders, supervisors, directors, etc. but by a small group of employees who are knowledgeable of a legacy data-entry system. These employees have formed such a strangle-hold upon this department that until the legacy system is retired, the company is held hostage. While working with this organization, it was shocking to see how pernicious and long-reaching this micro-network had become, how those in the micro-network parroted the beliefs and opinions of the micro-network core leaders, and how fast micro-network jobs could be completed, but the regular business could not be concluded.

Academic research calls micro-networks a host of names from mini-networks, to relationship-based networks, to value-added networks to professional social networks, always the intransigence towards change, and the core group manipulating a host of powerful people are the keys to identifying the micro-network. Important to note that these networks originate when a person needs some legitimate business completed and finds a like-minded person who can accomplish what is desired. The micro-network methods of subverting system control to perform work generally start harmlessly enough as a “hook-up.” Get enough “hook-ups” occurring, and a micro-network will form.

Macro-networks may contain micro-networks or members of micro-networks; the difference is the purpose of the network, what defines membership in the macro-network, and the work of that macro-network. A macro-network does not fear change as a micro-network does; which, is essential to understanding the macro-network. Macro-networks span across multiple subsystems, cultures, identities, behaviors, etc. A macro-network overlays and contains a vast majority of people.

For example, Catholicism could be considered the largest macro-network in human history. Catholicism has breed hundreds of other macro-networks in religion, child adoption, hospitals, food banks, and much more. No single Catholic is the same and generally has ties to another macro- and micro-networks. Each will interpret the tenets of Catholicism differently and apply the principles differently, but with some degree of sameness as well. Hence, the final aspect of a macro-network, it can replicate other self-sustaining macro-networks. In contrast, a micro-network cannot replicate or be self-sustaining.

Polarization is behavior multiplied as two or more sharply contrasting opinions, beliefs, biases, or behaviors draw like-minded people. Behavior is attitude, bias, emotion, and individual choice, stemming from the axiom, “As a man thinketh, so is he” (Proverbs 23:7). Thus, thoughts become attitudes, the attitudes feed into behaviors, and the entire organization begins to suffer according to the individual’s choices and consequences. Polarization is an extension of tribalism and is observed as people cluster into competing groups in a zero-sum game, where negotiation and compromise are perceived as a betrayal.

Polarization is not a micro-network but may originate within a micro-network that grew. A micro-network does not develop into a macro-network but into a tribe that is polarized. Polarization is all about antagonism, the demonization of other people outside the specific tribe, conformity inside the tribe along with greater demands to force conformity outside the tribe, lies, and deception are tactics to win new members to the tribe, and violence is seen as natural to combat others not in the tribe.

Consider the following example, changes to The US Senate’s rules regarding filibustering. While in the minority party, the leaders in the current majority party decried long and loud how changing the rules of the filibuster was unconstitutional, wrong, or out of line. Wait a year or two, watch the political party from the minority become the majority, and now changing the filibuster rules is considered acceptable, needed, and a step in the right direction to move the country forward. The rules of the filibuster did not change; the political aspects of the filibuster did not change; only the people in power changed and then the rules of the filibuster changed.

Polarization begets violence; consider the separation between the union and non-union employees. Go anywhere in the world where labor unions exist, and the violence between the union and non-union employees is always prevalent. Now, some may say, violence does not happen here; how do you know? Violence is not just hitting another person or threatening to shoot that person. Violence includes deprivation and neglect. Case in point, a stack of work is delivered to an employee; if that employee prioritizes the work according to personal benefit, violence is being perpetrated against those not in favor of that worker. Micro-networks breed this type of violence into the workplace as normal and acceptable behavior!

A recent call center experience occurred where, when a homosexual manager discovered a person was uncomfortable; he would violate the personal space of a victim as a method of exerting power. It did not matter if the victim had generally good or bad opinions of homosexuality; simply being uncomfortable was enough to “invite” the intimidation. The business never claimed this was violent or a contributing factor in higher churn rates for that manager’s team, but ask the victims, and they absolutely considered the actions as violent, oppressive, and a type of bullying behavior. The victims of this manager were all men, and all shared the same aversion to merely having their space invaded by a known and militant homosexual, who used his sexual choices to protect himself from claims of sexual harassment. The people who accepted his space invasions gained promotions, and other preferential treatments. Those not accepting his invasions were eventually either asked to leave or quit without notice.

What about the female who actively looks for reasons to be offended and claim sexual harassment; the law supports the female claims, and the business from the preponderance of caution will generally side with the female making allegations. The victims were bullied into silence. This call center female filed more sexual harassment claims than any other person in its multi-state organization. The victims were shocked to hear they had been accused of sexual harassment, and the word spread that men should stay away from this person. The productivity loss, employee churn rates, and morale cost estimates were staggering, but the female’s behavior was accepted. The call center was so polarized over this issue that threats, bullying, and intimidation against male employees caused stress-related workplace injuries.

Understanding begets opportunities; this is a simple axiom with tremendous potential for improving environments of polarization, reducing the power of micro-networks, and increasing the productivity of macro-networks. The power of polarization is only diminished when people start working together, seeing each other as valuable assets of the same organization. Hence, the first opportunity to bridging polarization is getting people to work together, which takes leadership, and it requires selecting people for projects outside the normal same ten people (STP). Reducing the power of micro-networks also requires leadership and selecting people for projects outside the STP. The following is not an all-inclusive list but a basic launch point:

Intergroup contact and the power of working together; one of the greatest work projects witnessed included people from a wide range of positions; they were set firm deadlines, objective standards of performing work, and a leader who desired them to work together. Sweat equity paid off in large dividends; when the leader allowed them space to work out their differences and room to work, the group was successful.
Communication must change! While most will conclude that the speaker must select their words differently to accommodate a polarized audience full of micro-network competing members, this perception is invalid! It is not the speaker who must change, but the listener. The listener must move from not listening through active listening to reflective listening. Reflective listening is a personal commitment to listen until mutual understanding has been achieved. Reflective listening requires asking and answering questions in a manner that produces dialogue.
Refuse to honor groups and instead honor individuals. Honest praise is better for the brain than cash gifts. Fake praise is more damaging to the individual than a bullet, a bludgeon, or a whipping. Leaders must create the time to honor individual efforts honestly, openly, and often if they are to change the culture where polarization and micro-networks exist. Issuing honest praise is as simple as writing “Thank You for…” on a sticky note. The point is to give truthful, genuine, and sincere praise!
Behaviors are not people; behaviors belong to a person who needs praise. Choose the focus carefully! A leader can spend all day on negativity and never achieve a team of people working together. Or, a leader can choose to spend the day recognizing efforts to improve and positivity and make the team into greatness. Choose carefully, choose consistently, and choose to exemplify that which you want to see in others.

Be the example! Exemplify reflective listening by investing time in listening. Exemplify the need to bridge between polarized points by bridging not between ideas and opinions, but people. Exemplify the need to eradicate micro-networks by insisting upon not using micro-networks when work is needed to be accomplished. Remember, those STP will burn out, choose other people, and help them discover how to perform work. Remember, at the end of the day, the solutions and opportunities all reside in the people. A micro-network is people who found a faster way of conducting company business with like-minded individuals. The root cause for micro-networks stems from broken processes and procedures that govern work. Welding that micro-network back into the macro-network will require getting the people working together and a different work process that eradicates the need for a micro-network. Early prevention of micro-networks prevents polarization!

© 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/

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