Just Because You Say It Doesn’t Mean It Will Happen

“Ordering a man to write a poem is like commanding a pregnant woman to give birth to a red-headed child.”
—Carl Sandburg

Former Veterans Affairs chief Eric Shinseki  was the whipping boy for the public issue of veterans waiting too long for health care. I believe he’s a very honorable man and a great American but am not writing to defend him.

I’m quite sure that the problems in the VA were prevalent before Shinseki took the job. However, as an executive, you have to own the problems. And sometimes you may not have caused them, but you didn’t fix them fast enough.

What interested me about this debacle when it first became public was the target that all patients be seen within 14 days of requesting an appointment. As we now know, VA employees figured out how to game the system with secret paper wait lists not entered into the system and switching off audit control functions in the software. Give them an A for creativity.  Senior management also gets an A, but unfortunately for naivety.

As this case points out, you can no more issue edicts from mahogany row and get good results than you can command a pregnant woman to give birth to a redhead. “Make it so,” as Jean-Luc Picard, captain of the USS Enterprise, used to say on Star Trek. Doesn’t really mean it’s going to happen.

There’s natural tension between performance and ethics. Push too hard on the numbers in a dysfunctional environment and creative things happen. Revenue gets counted in imaginative ways. Customer satisfaction data gets massaged. Orders are shipped with known errors just to be able to book them. (Famously, years ago a Colorado company literally shipped bricks in boxes rather than computer parts to book the revenue and then quickly recalled them. The executives went to jail.)

Setting objectives with no regard for how to meet them and no understanding of the behavioral changes required, the resources needed or the processes necessary is ridiculous. Owners and leaders of organizations have the position authority to demand what they want, but if the operational plans, compensation systems, customer desires, staffing, etc., aren’t thought through, they’ll likely end up with brunettes rather than redheads.

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