OFFICIAL PUBLICATION OF THE LOS ANGELES COUNTY MEDICAL ASSOCIATION
Los Angeles County Department of Public Health
Paving the Way for Health Equity
M AY/ J U N E 2 0 1 8
PLUS: LACMA to Swear In First African American President, C. Freeman, MD, MBA, FAPA
FOUR TIPS ON HOW TO MAINTAIN A POSITIVE CASH FLOW By: Patrick Nygren, San Fernando Valley Region Banking President, Community Bank, Wells Fargo & Company
A consistent positive cash flow can help small business owners grow their business, pay expenses, or event invest in new opportunities. According to our most recent Wells Fargo/ Gallup Small Business Index, small-business-owner optimism remains high as most owners expect a healthy cash flow this year. The January 2018 survey found 77 percent of Patrick Nygren small-business owners rated their company’s cash flow as very good or somewhat good over the past 12 months, which is up from 73 percent in November 2017. To help small businesses owners with managing cash flow, below are four tips you should consider. PLAN IN ADVANCE FOR CASH SHORTAGES | An important tool for planning ahead is a cash flow forecast, typically a one-year prediction of how cash will move in and out of the business. This helps small business owners evaluate how profitable future sales will be, and provides an overview of what needs to be done to reach your goals. In its simplest form, a cash flow forecast should show where cash balances will be at certain points in the future, so you can anticipate and prevent cash shortages. To get started, organize your payables and receivables on a spreadsheet to see where the money is coming and going. KEEP A RAINY DAY FUND | Expect the unexpected. Typically
cash flow will vary, and unexpected expenses will occur even for established businesses. Keeping a rainy day fund
with three to six months of basic operating expenses in a reserve can prepare you for slow periods and emergencies. Another option is to use a business credit card or business line of credit to pay for everyday expenses and help bridge gaps in cash flow. Be sure to monitor your expenses with online banking and monthly statements. ALIGN YOUR REVENUE STREAM WITH PAYROLL CYCLES |
Some businesses, such as restaurants and retailers, generate daily revenue and can more easily cover the expense needed for weekly payroll. For others, such as manufacturers, this could be a challenge, and you may benefit from paying employees less or more frequently, provided applicable wage laws allow you to do so. Refer to the state Department of Labor for pay frequency information. SPREAD OUT YOUR PAYMENTS | Paying all your business bills at the same time rather than spreading them out can drain your disposable income and leave you at risk of not being able to pay your creditors and suppliers if an unexpected expense occurs. Instead, try paying your bills closer to the due dates and negotiate with your vendors to see if you can extend your payables to 60 or 90 days. Also, be sure to pay your most important bills first, such as rent and payroll, before paying less important bills. Check with your vendor to see if you can receive discounts for paying any bills early. Remember to pay all your bills before the due date to maintain a good credit standing.
Being able to serve your customers effectively while reaching your highest potential as a small business owner depends on maintaining positive cash flow. Following the four tips above may aide in not only keeping your business financially strong, but also in positioning your company for future sustainable success.
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EDITOR Sheri Carr | editors@physiciansnewsnetwork.com ADVERTISING SALES Dari Pebdani 858.231.1231 | dpebdani@gmail.com EDITORIAL ADVISORY BOARD David H. Aizuss, MD Troy Elander, MD Thomas Horowitz, DO Robert J. Rogers, MD
VOLUME 149 ISSUE 3 | MAY/JUNE 2018
HEADQUARTERS LOS ANGELES COUNTY MEDICAL ASSOCIATION 1055 West 7th Street, Suite 2290 | Los Angeles, CA 90017 Tel 213.683.9900 | Fax 213.226.0350 www.losangelesmedicine.org LACMA OFFICERS PRESIDENT | William K. Averill, MD PRESIDENT-ELECT | C Freeman, MD TREASURER | Sion Roy, MD SECRETARY | Diana Shiba, MD IMMEDIATE PAST-PRESIDENT | Vito Imbasciani, MD
William K. Averill, MD A MESSAGE FROM LACMA CEO
Gustavo Friederichsen
LACMA BOARD OF DIRECTORS COUNCILORS-AT-LARGE Jerry Abraham, MD (1) Samuel Fink, MD (6) Jeffery Lee, MD (6) Maria Lymberis, MD (5) Nhat Tran, MD (9)
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PRESIDENT’S LETTER
TRUSTEES & CHAIR DELEGATION Peter Richman, MD, CMA Trustee Jack Chou, MD
Facey Medical Group: Serving LA County’s Valley for Nearly a Century LACMA TO SWEAR IN NEW PRESIDENT
C. Freeman, MD, MBA, FAPA
COUNCILORS Robert Bitonte, MD, JD (D1) Stephanie Booth, MD (D3) Troy Elander, MD (D5) David Hopp, MD (D7) Omer Deen, MD (D9) Christine Phan, MD (D10) Sidney Gold, MD (D17) Roxana Yoonessi, MD, JD (SCPMG) Heather Silverman, MD (SSGPF) Po-Yin Samuel Huang, MD (1, YP Councilor) Hector Flores, MD (1, EPC Chair) Laura Halpin, MD (Resident Councilor) Erik Berg, MD (Alt. Resident Councilor) Ali Tafreshi (Student, USC) Gwendolyn Lee (Alt. Student, UCLA)
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LACMA’s Board of Directors consists of a group of 30 dedicated physicians who are working hard to uphold your rights and the rights of your patients. They always welcome hearing your comments and concerns. You can contact them by emailing or calling Lisa Le, Director of Governance, at lisa@lacmanet.org or 213-226-0304. SUBSCRIPTIONS Members of the Los Angeles County Medical Association: Los Angeles Medicine is a benefit of your membership. Additional copies and back issues: $3 each. Nonmember subscriptions: $39 per year. Single copies: $5. To order or renew a subscription, make your check payable to Los Angeles Medicine, 10755 Scripps Poway Parkway, Suite 615 | San Diego, CA 92131. To inform us of a delivery problem, email editors@physiciansnewsnetwork.com. Acceptance of advertising in Los Angeles Medicine in no way constitutes approval or endorsement by LACMA Services Inc. The Los Angeles County Medical Association reserves the right to reject any advertising. Opinions expressed by authors are their own and not necessarily those of Los Angeles Medicine, LACMA Services Inc. or the Los Angeles County Medical Association. Los Angeles Medicine reserves the right to edit all contributions for clarity and length, as well as to reject any material submitted. Los Angeles Medicine is not responsible for unsolicited manuscripts.
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PAVING THE WAY FOR HEALTH EQUITY An Interview with the Director of the Los Angeles County Department of Public Health Dr. Barbara Ferrer
Why Managers Learned Everything They Need to Know in Kindergarten and then Promptly Forgot
Los Angeles Medicine (ISSN 1533-9254) is published bimonthly (Jan/Feb, Mar/Apr, May/Jun & Jul/Aug, Sep/ Oct, Nov/Dec) by LACMA Services Inc. (a subsidiary of the Los Angeles County Medical Association) at 801 S. Grand Avenue, Suite 425, Los Angeles, CA 90017. Periodicals Postage Paid at Los Angeles, California, and at additional mailing offices. Volume 143, No. 04 Copyright ©2012 by LACMA Services Inc. All rights reserved. Reproduction in whole or in part without written permission is prohibited. POSTMASTER: Send address changes to Los Angeles Medicine, 1055 West 7th Street, Suite 2290 | Los Angeles, CA 90017. Advertising rates and information sent upon request.
A PUBLICATION OF PHYSICIANS NEWS NETWORK 10755 Scripps Poway Parkway, Suite 615 | San Diego, CA 92131 | Tel 858.226.7647 | www.PhysiciansNewsNetwork.com
LACMA PRESIDENT
W I L L I A M K . AV E R I L L , M D
Assembly Bill 3087 MORE THAN 500 PHYSICIANS recently delivered a clear message to state legislators: Assembly Bill 3087, ill-conceived by Ash Kalra (D-San Jose), is a radical physician rate-fixing proposal that would increase patient out-of-pocket costs, create state-sanctioned rationing of healthcare for Californians, and force physicians out of state or into early retirement. By fixing the price for all medical not already controlled by the According to the California services government, this bill would eliminate Hospital Association (CHA), commercial markets and impair both timing and the quality of care the bill would cause an the California patients could receive. estimated 175,000 hospital According to the California Hospital Association (CHA), the bill would cause workers to lose jobs and could an estimated 175,000 hospital workers force many hospitals and to lose jobs and could force many medical practices to close. xxx hospitals and medical practices to close. Many physicians who serve Medi-Cal patients believe AB 3087 would force them to decrease the number of Medi-Cal patients they serve. No other state has attempted such an inflexible government-managed policy. AB 3087 would be catastrophic.
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William K. Averill, MD President, Los Angeles County Medical Association
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LACMA CEO
G U S TAV O F R I E D E R I C H S E N
IN CASE YOU HAVEN’T NOTICED, there is much more going on at LACMA, in medicine and
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throughout the healthcare industry than meets the eye. A battle wages to defeat Assembly Bill 3087, the egregious anti-physician bill aimed at price fixing. And, who’s fixin’ to set prices? A nine-member government commission composed of non-physicians. Our collective goal is to make sure AB 3087 doesn’t reach any semblance of passage. At CMA’s annual legislative lobby day this past April, LACMA members had the chance to meet privately with local legislators and discuss AB 3087, how it will impact the practice of medicine and will erode healthcare in the state. Doctors will leave. Hospitals will have to reduce staff, and some estimates point to more than 175,000 jobs lost as a result of this bad bill. This is also the season of political campaigns. LACMA’s leaders have met with candidates running for Senate and Assembly seats to determine who will best serve the needs of the medical community, who understands medicine and who will fight for physicians and patients alike. To stay informed, visit the LACMA website for our ongoing member communications. As we wrapped up the Saving Private Practice Consortium 2.0 on March 3, we heard from many of the 100-plus physicians about their experiences, what they liked and what they did not like, and the bottom line is that almost all attendees got help from top industry experts who participated that day. As promising as that feedback is, we know we have more to do. My responsibility to all members is to ensure that the same value is delivered not just during a one-day event, but every day. I encourage you to visit losangelesmedicine.org or follow us on social media to engage and learn more about the resources and benefits available to you. I can guarantee that, like many who attended the Consortium, you can more than make up for your annual dues if you take advantage of your benefits. As evidenced by the united fight against AB 3087 and LACMA’s effort to collaborate with companies that support private practices, medical groups, and our hospital and health system partners, we are entering the spring with a sustainable platform, one that embraces change and fundamentally is built for physicians in any modality. I salute the physician members and leaders who are working relentlessly to draft, support or fight the very legislation that is proposed in the Capitol every day, all in favor of upholding the essential tenets of building healthier communities and ensuring access to care and fair payment for providers. At the same time, I am encouraged by the progress made to build a better organization with a clear and distinct eye on outcomes, performance and milestones — the same standards our members abide by. Ultimately, I hope that all members will renew their commitment to their profession and to the power of organized medicine.
I salute the physician members and leaders who are working relentlessly to draft, support or fight the very legislation that is proposed in the Capitol every day, all in favor of upholding the essential tenets of building healthier communities and ensuring access to care and fair payment for providers. xxxx
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Gustavo Friederichsen Chief Executive Officer
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Serving LA County’s Valley for Nearly a Century Facey Medical Group, which now comprises more than 180 physicians working at 12 medical centers throughout three valleys in the Los Angeles area, grew out of a solo practice that was started in 1923 in San Fernando by a physician named Frederick Facey. Ninety-five years later, Facey Medical Group and its providers are committed to the same values that Dr. Facey followed: growth, service, innovation and quality care. Facey Medical Group officially formed in 1955 when Dr. Facey realized the need for expansion and opened a new facility on Brand Boulevard in San Fernando. His vision at this time of burgeoning residency training was to create a multispecialty group with board-certified physicians. With eight physicians, and more space, the Facey Medical Group practice established a reputation for providing high-quality care and service to the San Fernando Valley community. In 2012, Facey Medical Foundation and Facey Medical Group established a strategic affiliation with Providence Health & Services Southern California. The combined resources within the Providence-Facey affiliation provided a strong and natural foundation to move forward with the goal of transforming the delivery of clinical care, a high priority for both Facey and Providence. Since 2012, Facey has rapidly expanded, adding six new facilities throughout the valleys north of Los Angeles. While focusing on the addition of new healthcare providers, cuttingedge technologies and patient-centered care, Facey Medical
Group remains rooted in its commitment to its local communities. “Our tradition has been to stay near to our primary geographic service areas of the north-central and northwest SFV and the Santa Clarita Valley,” says Frederick Russo, MD, president of Facey Medical Group, in a recent interview with LACMA. “But in the past six to eight years we have expanded our presence into the Simi Valley and the more southern communities of the SFV. Basically, we have strategically maintained our presence in contiguous areas to maintain continuity of care and accessibility of ancillary services for patients.” Being at the forefront of patient-centered care and innovation is not new to Facey. In fact, Facey was one of the few multispecialty staff model groups to be established as far back as the 1950s. It was also one of the first few groups to deploy electronic health records in 2002. Innovation, quality service and clinical excellence are hallmarks of any successful medical practice and can be achieved only through a strong network of dedicated clinicians who understand the sacrifice and reward of providing good care. That is why Facey is especially attentive to its physicians’ needs, “oftentimes tweaking work schedules to reduce extra burdens so as to reduce work stress and the risk of burnout,” says Dr. Russo. Facey is also unique in that it encourages a bottom-up, democratic culture, when possible, to cultivate professional satisfaction.
Where Do LACMA and Facey Meet? Advocacy is important. The California Medical Association (CMA) and the Los Angeles County Medical Association (LACMA) are making their voices heard on issues physicians care about, and LACMA is continually striving to find new and better ways to inform doctors about legislation affecting them at a county, state and national level. “Sacramento is important to us,” Dr. Russo says, “and Facey has been privileged to be part of formulating the CMA position. Locally, some of our key physicians have also had a voice in decision-making at LACMA.” In addition, Dr. Russo believes that LACMA and CMA provide a platform for greater emphasis on professionalism, collegiality and “our professional commonality towards care delivery and preservation of every mode of practice.” Moreover, LACMA and CMA support Facey, like other medical groups in Los Angeles County, in finding solutions that can effectively help with physician burnout, clinical outcomes and
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adoption of new technologies to improve patient care. Facey Medical Group continually strives to enhance customer service and access to care through its tight-knit community of patients and physicians. Dr. Russo believes it is an ongoing evolution and, as new leaders are cultivated, there will be an increased focus on making it easier for patients and physicians to leverage technology to make care delivery more efficient and effective. The Los Angeles County Medical Association and California Medical Association are proud to have a long-standing partnership with Facey Medical Group and are grateful for the contributions of Dr. Russo as well as those of Roscoe Marter, MD, Facey’s vice president, and Erik Davydov, MD, Facey’s medical director, who, among many others, are carrying the tradition of local service, innovation and superior patient care into a new era. LACMA and CMA are honored to be part of their journey.
Installation of Officers June 21 | 6:30–9:30 Hotel Casa Del Mar, Santa Monica
LACMA to Swear In First African American President
C. Freeman, MD, MBA, FAPA
RSVP to Lisa Le at lisa@lacmanet.org or (213) 226-0304
Dr. C. Freeman is set to make history when she becomes the Los Angeles County Medical AsAs the first African American sociation’s first African American LACMA president, I am both proud and African American female president on June 21 at the orof the organization’s evolution to ganization’s Annual Installation of Officers in Santa Monica. C. effect such a pivotal change in its Freeman, MD, MBA, FAPA, is the daughter of the famed educator traditional leadership and honored and orator Dr. Thomas F. Freeman of Houston, Texas. to lead our group in what is shapDr. Freeman holds a vision to lead the medical community ing up to be a year of new levels into a renewed era of physician empowerment and patient-centered of inclusion and active advocacy, care, stemming from trends indicating that increasing bureaucratic and technological requirements have diminished the individuality and which increases the value for more personal touch of quality healthcare. During a pivotal time when healthcare providers are enduring physicians and has the highly unprecedented levels of hardship and burnout, through powerful advocacy and unity, Dr. Freeman is committed to providing an effective desirable side effect of stimulating platform for physician leaders of all specialties and modes of practice to come together, engage and rediscover the joy of practicing medicine growth in membership, involveand the meaningful purpose of helping others. A geriatric psychiatrist affiliated with California Hospital Medical ment, affiliations, and impact. Center in Los Angeles, Dr. Freeman is now the program director for the newly accredited Psychiatry Residency Training Program at Charles R. Drew University of Medicine and Science. She received her medical degree from Howard University College of Medicine and dual training in internal medicine and psychiatry at the University of Virginia, and has been in practice for more than 20 years. Dr. Freeman currently serves on the LACMA Board as president-elect. She lists membership MEDICAL PRACTICE PURCHASES, SALES AND MERGERS and leadership in organizations such as the National Medical Association, National Black MBA Association, Charles R. Drew Medical Society, Black Psychiatrists of America and American Psychiatric Association. There have been only four female physician presidents since LACMA’s founding in 1871. Dr. Rose Bullard was the first female president elected in 1903. LACMA would not elect another female president again for another 89 years. Never in its history has LACMA elected an African Assisting physicians with American president. legal issues for over three decades. LACMA CEO Gustavo Friederichsen said, “With a continued focus on changes in healthcare from Fenton Law Group, LLP the national level all the way down to a local level, 1990 South Bundy Drive we’re excited by Dr. Freeman’s refreshing approach Suite 777 to organized medicine and the impact her leaderLos Angeles, CA 90025 The brand physicians trust ship will have on the practice of medicine and our 310.444.5244 www.fentonlawgroup.com role as an association to support all physicians and the health of our local communities.”
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MEDICAL BOARD HOSPITAL STAFF F R A U D / A B U S E MEDI-CAL/M E D I C A R E
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Paving the Way for Health Equity in Los Angeles County Just over one year ago, Barbara Ferrer, PhD, MPH, MEd, was appointed as the director of the Los Angeles County Department of Public Health by the Los Angeles County Board of Supervisors. Dr. Ferrer brought not only over 30 years of professional experience as a philanthropic strategist, public health director, educational leader, researcher, and community advocate to the position, but also a collective vision for LA County: that everyone has the opportunities and optimal resources for health and well-being. So was established the Los Angeles County Health Agency Center for Health Equity. In a recent interview with Gustavo Friederichsen, CEO, Los Angeles County Medical Association, Dr. Ferrer shed some light on the research that led to the formation of the Center and its main focus areas for achieving optimal and equitable health for all in LA County. “If you look at population data and the LA County population as a whole, in many regards we are a very healthy community. When you start looking at the data for specific groups of folks or by residential neighborhoods, you see a different picture of LA. In fact, some people call it a picture of two LAs or three LAs. In particular, African American members of the LA County community are doing far worse on a whole host of measures than all of our other residents. Native Americans also fare significantly worse than others, and Hawaiian Natives fall into a similar category. So by race and ethnicity we see some dramatic differences that, in fact, aren’t easily explained by income or educational levels,” Dr. Ferrer told Friederichsen. With an unjust distribution of resources and opportunities in our local communities, health disparities are mostly afflicting underserved and ethnic communities. Tackling these inequities, however, is not just a matter of focusing on changes in clinical care, but looking at the larger picture of the resources individuals have to lead healthy lives, including access to economic resources, educational resources, environmental, and cultural competency resources. Dr. Ferrer understands that it is complicated and complex, but is optimistic that Los Angeles County’s leaders and residents can work together to achieve system, policy and practice changes that lead to health equity. “LA County is a progressive and committed set of people. The Board of Supervisors stands above all other leaders in really acknowledging what it means to be of service to our community, and they do that by insisting that every day we put front and center the needs and voices of residents. When you put the needs and the voices front and center, you are going to make a difference…There is an opportunity for us in LA County to lead the way on how we can ensure that residents have what they need in order to fully contribute and be healthy.”
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THE FIVE KEY INITIAL INITIATIVES | The Center for Health Equity has outlined five priority areas to eliminate differences in health outcomes based on where a person lives, their sexual orientation, and/or their race or ethnicity: • • • • •
Infant Mortality Sexually Transmitted Infections Cultural and Linguistic Competency Healthy Neighborhoods Environmental Justice
The gaps in health outcomes seen within the Center’s focus areas are not necessarily caused by personal health behaviors or characteristics. They are mostly the result of past and present policies and practices influenced by racism, sexism, transphobia, homophobia, and other prejudices. These policies and practices lead to inequitable conditions that limit an individual’s ability to grow healthy and thrive. Dr. Ferrer emphasized the need for medical communities across the county to not only mobilize to improve service quality, provision and coordination, but also to collaborate to better address the conditions and policies that drive and maintain health inequities.
GOING BEYOND THE PRACTICE: THE PHYSICIAN’S ROLE IN HEALTH EQUITY | Dr. Ferrer believes that LA County is at a strong advantage in advancing health equity because of its “very strong provider network” and “a network that understands the critical role that prevention plays in promoting healthy outcomes.” All of the five key focus areas require action on behalf of the medical community. Achieving optimal health, especially for those communities impacted by social injustices, will require physicians to make changes inside and outside of a clinical setting. First, providers can ensure a welcoming and culturally respectful environment for patients and employees. As one of the most diverse communities in the country and with 60-70
languages spoken throughout the county, Dr. Ferrer believes that recognizing how implicit bias affects trust in relationships with employees, with each other and with the community is an important first step providers can take in developing cultural and linguistic humility to address the needs of local communities in building equitable care. Next, with a disproportionate burden of illnesses and an inequitable distribution of health resources among populations unjustly singled out by race, ethnicity, sexual orientation, gender identity and/or religious affiliation, it is important that practices adjust to understand the unique needs of individuals who experience high levels of stigma. These stigmas oftentimes can cause increased levels of chronic stress. Physicians should acknowledge and understand those stressors and assist with treatments that help the patient manage that stress in a positive manner. Regarding sexually transmitted diseases, a disproportionate number of STI cases occur among men who have sex with men (MSM), African American women, transgender persons and young people, with youth of color disproportionately affected. Dr. Ferrer believes that novel, coordinated action is needed to address the complex factors affecting STI rates countywide and placing some communities at higher risk. In addition, Dr. Ferrer stressed the importance of better screening and treatment among those populations seeing increasing rates of STDs. In LA County, the infant mortality rate of black babies is three times higher than the rate of white babies. Closing this gap will require developing innovative strategies with physicians to improve preconceptual, prenatal, and interconceptual care. Lastly, Dr. Ferrer urges all clinicians to pay attention to policies that influence access to healthcare and resources for healthy communities. In particular, there is a need to focus on policies that mitigate against climate change because of the dramatic impact it will play in disease burden. She said that we should all learn from past examples of policies around tobacco control, seatbelt regulations, and clean water that have been game changers in improving healthy environments. Additionally, whether physicians are in large provider groups or in solo practice, it is important to consider environmentally conscious purchasing options that would support issues addressing climate change and protecting the Earth.
LACMA’S ROLE | When it comes to policy, LACMA and its partnership with the California Medical Association is arguably the most influential healthcare advocacy organization at the county and state levels. Our members carry immense credibility when sharing their voice and representing the voices of their patients. That is perhaps one of the main ingredients in helping to achieve health equity in LA County. Dr. Ferrer mentioned the importance of getting clinicians involved in shaping the strategies around the five initiatives. “We don’t have the answers; we know where we would like to go, but we need clinicians to help us figure out the action plans and what is going to take us there. So I think that is one task. Get involved. Join our planning groups and really help make sure that the voice of providers is being elevated in terms of the solutions and strategies that are being promoted,” Dr. Ferrer said. Most importantly, leveraging the health policy-making platform of LACMA and CMA will be key in creating policies that will keep our communities protected and healthy. That can mean advocating beyond clinical issues to address the social determinants of health, like fighting for a living wage, paid sick leave, fair housing policies, among others.
“Get involved. Join our planning groups and really help make sure that the voice of providers is being elevated in terms of the solutions and strategies that are being promoted.”
THE JOURNEY AHEAD | In describing the incredible and promising journey ahead, Dr. Ferrer said, “I’d like to start from a place of deep gratitude for physicians. I think the job is really tough, and I think there are a lot of constraints on clinicians who want to practice the best medicine possible…I think of care as a continuum from prevention all the way through recovery and healing. We each have our specific roles to play, but the most important thing is that we understand each other’s roles and places of contributions, so we are connecting these dots on behalf of our patients and our residents…We both have the science and the political will to actually come together and make this happen. I am excited about it.” TO LEARN MORE AND GET INVOLVED, PLEASE VISIT: HEALTHEQUITY.LACOUNTY.GOV
Dr. Barbara Ferrer works to further the Los Angeles County Health Agency’s mission to integrate services and activities that enable the Health Agency to build health equity across the county. The Department of Public Health is one of three agencies that make up the Health Agency. Prior to her appointment, Dr. Ferrer was the chief strategy officer for the W.K. Kellogg Foundation, where she oversaw key program areas, including food, health, and well-being. She was also the executive director of Boston’s public health department and headmaster at a district high school in Boston.
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A LARGE PERCENTAGE OF EMPLOYEES WILL NOT SUE WHEN THEY HAVE BEEN GIVEN A FAIR OPPORTUNITY TO PRESENT THEIR THOUGHTS AND HAVE THEIR CONCERNS ADDRESSED, EVEN IF THE END RESULT IS NOT WHAT THEY DESIRED.
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Why Managers Learned Everything They Need to Know in Kindergarten AND THEN PROMPTLY FORGOT
We have all seen the “Everything I know, I learned in kindergarten” poster on a teacher’s wall or a friend’s Facebook post. It resonates because it holds some very simple truths. While the problems that we encounter in the workplace have far more serious implications than who got to use the red marker first, the way in which we interact and resolve conflicts amongst employees could be more successful if we returned to rules and values we learned years ago. As an experienced employment attorney, I have seen situations quickly escalate from minor misunderstandings to costly, mudslinging lawsuits. When the opposing parties get entrenched in their positions, and both want to be declared “right,” there are missed opportunities to reflect on the viewpoints of everyone involved, and to offer respect, an explanation, and maybe an apology for unintentionally hurting someone. A large percentage of employees will not sue when they have been given a fair opportunity to present their thoughts and have their concerns addressed, even if the end result is not what they desired. Below are some suggestions for how management professionals can better strengthen their teams and open the channels for problem solving, using techniques they already have in their toolkits. SHARE EVERYTHING | What does this mean in the workplace setting? Figura-
tively, it means sharing the goals and the struggles of the business. Employees who are not included in the vision of the business or the challenges that are encountered often feel like a cog in the wheel. An overlooked cog in the wheel. Maybe they don’t understand that the boss took away the fancy coffee machine because there is a priority on making payroll and cash flow is on a decline. Perhaps the implementation of a time-clock system or a new policy is because the company was exposed to liability and needs to protect itself and, in turn, its employees. Sharing everything means giving an explanation as to why someone received the coveted promotion; it is not because they know the boss’s wife’s third cousin, but because they wrote a proposal to a client that increased the cost of the sale by 25%. When decisions are made at the top, and the only communication made to the employees is the result, not the reasoning, it can lead to the wrong conclusions being drawn. Even if the employee’s job is mundane, or not highly skilled, there is room to make them feel included and to understand how their contribution impacts the greater goal. It is not a weakness to share the ups and downs of the business; it creates an investment in success.
PLAY FAIR | When management makes decisions that affect employees’ terms,
About the Authors: Alexis D. James and Renee N. Noy are employment attorneys and co-owners of the firm, WorkWise Law, PC. Having practiced on both sides of the employment equation, for a combined 27 years, Alexis and Renee are solely focused on aiding business owners with their legal compliance requirements and preventing unnecessary disputes. Recent speaking engagements include the National Association of Women Business Owners, Professionals In Human Resources Association, Southern California Association for Hospital Risk Management, and the Los Angeles County Medical Association.
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conditions, and benefits of employment, without considering the consistency of those actions, discrimination claims surface. The decisions may be made without any discriminatory intent; however, from the employee’s viewpoint, it may feel like they are being singled out or scrutinized, or watching others receive opportunities that they feel they should have been given. Children are very much attuned to ideals of fairness. For those of us who are parents, we often hear our children say, “He got more cookies than I did” or “She gets to stay up later watching TV.” When we respond to these statements we usually give an explanation that involves the reasoning we used: “He ate his vegetables, so he got two cookies” or “Your sister is older than you.” Adults in the workplace are equally observant as to who gets what, and why. The best thing management can do to protect the company from liability is to apply policies and practices consistently and fairly across the board. If the employee knows that the corner office is given to the most senior staff member, there is a managed expectation that they will receive that perk when their seniority trumps everyone else. When workers feel that there is an even playing field, it creates a more positive and healthier work environment.
SAY YOU’RE SORRY WHEN YOU HURT SOMEBODY | In this
litigious society, there is a feeling that an apology will automatically be an admission of guilt and could affect legal liability. Yet, in many of the lawsuits brought on behalf of employees, they just wanted an acknowledgment that a mistake had been made. Perhaps, the employer miscalculated the length of a disability leave, or failed to consider an accommodation that would have allowed an employee to get back to work. Or, maybe the manager did not consider all the pertinent facts in their performance review before denying the bonus. I was often asked by clients during a settlement negotiation if the company would write a letter of apology or convey some feeling of remorse. We tell our children to own up to their mistakes and to apologize. Why then, as adults, do we avoid the two words that may smooth over the conflict and allow the participants to move forward? The power of an apology should outweigh the fear of admitting a failure.
DON’T TAKE THINGS THAT ARE NOT YOURS | This piece of advice is not about swiping the last piece of strawberry pie in the office fridge that has “MIKE” written all over the box. This tip concerns the abuse of power and taking credit for someone else’s efforts. I had a case where a marriage and family therapist had implemented a new patient screening process and the younger woman who was her boss implemented it as if it was her idea. In addition to other factors, my client felt she was being pushed out due to her age, and that her contribution to the clinic was no longer valued. The best leaders recognize and advance the efforts of those they supervise. This is truly the mark of a superior leader. Taking credit for something that is not yours will inevitably lead to contempt, which results in bitterness and resentment.
USE YOUR WORDS | If I had a nickel for every time I told one of my kids to “Use Your Words” I would be sitting on a beach in Hawaii right now. Instead, I advise my management clients to use their words in a few different contexts. Documentation of performance deficiencies or conversations where expectations and guidance were given are key to protecting an organization. Management must write down key discussions with an employee, with the mind-set that these memorialized discussions could be used as evidence in a courtroom. Written proof of coaching (e.g., an email, memo, log, etc.) is a powerful tool to demonstrate that an employee was warned and given opportunities for improvement prior to an adverse action being taken. Second, managers must be conscious of the power of body language. Yelling, screaming, pointing a finger, standing over someone’s shoulders may convey that expectations are not being met, but it will not accomplish the goal of getting the employee to comply. As with any healthy relationship, communication and mutual respect are key. Management must make an effort to listen and to express their observations in a non-threatening and non-demeaning manner. THE GOLDEN RULE | So often in employment lawsuits, the issue decided is whether management was “following the law” or whether they were acting with a discriminatory intent. After all the arguments and motions and documents are presented, the question that jurors wrestle with becomes very simple. Jurors ask themselves, “Did the employer treat the employee the way they (the jurors) would want to be treated?” While lawmakers make things more complicated than necessary, our collective sense of justice is still informed by the golden rule. Now is the time to take these childhood lessons out of the old crayon box, dust them off, and create workplaces that reflect the pledge we said in unison, “with liberty and justice for all.”
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