Monday, March 23, 2009

Observations on value-driven behavior

The recent extensive publicity about my approach to addressing budgetary problems at BIDMC is a bit discomfiting to me personally. While it is always nice to get good reviews and favorable press, I view what we are doing as so consistent with the values of the people at BIDMC that I think that the praise that is being applied to me individually seriously misses the point. Yes, leadership really matters. But after all, it is our staff who are choosing to make sacrifices to help avoid layoffs and to help the lower wage workers in our hospital. They are the true heroes, whom people need to be focusing on most. If they didn't have the core values they are showing these days, nothing I or any other leader could do would matter.

Clearly, there is something bigger going on, something I had not fully understood or anticipated. I have come to conclude that the credit being given to me is reflective of something that people seek and need during these rough times. Thomas Friedman writes about it in yesterday's New York Times, citing a lack of leadership at the national level that would draw people to think more deeply about their values and to act on them.

“There is nothing more powerful than inspirational leadership that unleashes principled behavior for a great cause,” said Dov Seidman, the C.E.O. of LRN, which helps companies build ethical cultures, and the author of the book “How.” What makes a company or a government “sustainable,” he added, is not when it adds more coercive rules and regulations to control behaviors. “It is when its employees or citizens are propelled by values and principles to do the right things, no matter how difficult the situation,” said Seidman. “Laws tell you what you can do. Values inspire in you what you should do. It’s a leader’s job to inspire in us those values.”

Dr. Lachlan Forrow, an ethicist at BIDMC, thinks that Mr. Friedman has it just slightly wrong. In a note to me, he says, "I do not think it's true that what the most effective leaders do is "inspire in us those values" (though yes, that's part of the story), as much as embody them, honor them in the rest of us, encourage and facilitate their expression/release, and then celebrate that release so there's a positive feedback loop."

I really like Lachlan's formulation of the case. In an earlier post, I referred to Lois, a manager in our Department of Medicine, who taught me that our community's approach had contributed to her ability to deal with the fear of the moment, enabling her to be able to be generous to others. This was extremely touching and meaningful to me and supports Lachlan's statement.

Last week, I heard about a priest in Duxbury, MA who was using our hospital's experience to make the same points. I thought this was an isolated case, but then a friend sent me this link to a pastor in Concord, MA. I remain a bit abashed by the personal nature of the post, but I need to share with you the lesson that this preacher set forth and to commend his leadership in doing so for his congregation. And I am grateful, too, for how he empowers our own staff at BIDMC -- regardless of their religious beliefs -- to further greatness by specifically citing their good deeds.

The employees at Beth Israel Hospital may or may not be Christians, but they certainly give us Christians a sign of the kind of giving our faith requires of us.

It’s always easy to give from our surplus,
from what we don’t really need. But the love of Jesus asks us to give from our want: to give even when we don’t have enough to give or when it seems we have nothing left to give.

The more this economy pinches and squeezes and drains us,
the more real will become the options faith sets before us.

May the sacrament we share here nourish in us
the love that gives freely of itself for the sake of others.


Lachlan Forrow, MD, FACP said...

ConcordPastor's self-identified Christian perspective reminds me of something my father once told me. A Christian church in Connecticut where my parents live had some major facility problem and had to find some other temporary place to worship. The rabbi of a nearby synagogue offered his synagogue. Responding to this unexpected generosity, the Christian minister said to the rabbi: "This is wonderfully Christian of you." The rabbi smiled and said "Well actually, I'm just being very Jewish."

As someone with Christian ancestry whose professional life and values have been so heavily shaped by the Jewish heritage of Beth Israel Hospital, I enjoy celebrating the convergence of values we're seeing here, deeply rooted in more than one faith tradition, but actually quite universal. And what I even more enjoy is that in today's BIDMC we also have Muslim, Hindu, Buddhist, atheist, and other colleagues who bring the same SPIRIT out of their own perspectives.


Anonymous said...

We hope that now all want to be involved in the medical system is improved, but not because they think the medical system is very much less come to trust that these events will reduce the cost and benefit millions of people throughout the country, and they say that things in improved from 60% in recent weeks, hopefully this is the case ..

Anonymous said...

do unto others as you would have them do unto you is a universal theme. The actions and behavior by the BIDMC so hammer this home to people of all faiths.
The attitude and fortitude of the people of BIDMC is why the SEIU will ultimately fail in it's relentless pursuit of BIDMC. You and your employees are already a union of committed, principaled people who not only talk the talk, but walk it as well.

Anonymous said...

Would you ever want to work at another institution? That is the question right now. I see how so many people have pulled together and I personally would not choose to be anywhere else in such a time when we all need to pull together. I have seen it here first hand how quickly sacrifices have been made and it is by many of our own choices. It is both a privelege and an honor to work here at BIDMC and when we can come together in what may be our hardest time we may ever experience while being here, why would anybody choose to be anywhere else? I give tremendous credit to our President for his professional yet personal sacrifices and to leading the way to showing all of us that we can do this and still know we'll get through it if we all do it together! If you step back and see what we have given up, I'm hoping others see the big picture as I do and understand it is nothing knowing that we have saved jobs and kept people's families housed and fed. What may be a couple small sacrifices to us is a savior of an end for another family!

Anonymous said...

I find it somewhat fitting that this is all happening during Lent. I teach my Sunday school kids that during this season, giving something up for yourself is good, but doing something good for another person every day is even better. There are so many selfless individuals who are so vested in the success of BIDMC (loved Mary Ann Stevenson's "Harvard with a heart" reference--got to love her--how could you not?). It's a great story ...thanks for being the conduit for change.

Unknown said...

I got here from Fr. Austin's blog, and I see BIDMC sort of from the outside - I work as a Paramedic for one of the Boston area's ambulance companies, and I'm in and out of the hospital often when I work a shift. What I see is good, but this really does hammer home what you're about to the people who you serve as well as to the people who work there.

You and Fr. Austin have the same goals, whether you realize it or not. Obviously your constituencies are different, but the things you both want to accomplish are remarkably similar.

Nice post.

Concord Pastor said...

I'm grateful, Paul, for your linking our blogs and for the fruitfulness of that connection!

-Austin Fleming