Healthcare “Syntopical”: The Company That Solved Healthcare 2 (part 3 of 15)

The Company That Solved Healthcare
John Torinus

Introduction

For the sake of clarity, I have chosen to group the successful reforms in the private sector under three platforms:

  • Consumer Responsibility
  • Centers of Value
  • Prime Role for Primary Care

Consumer Responsibility

Companies that have used what are called consumer-driven health plans have enjoyed savings of 20-40 percent. That’s because their employees have their own skin tin the game. Behaviors change on a dime when companies give their people personal accounts that are tied to high deductibles and co-insurance. They become more personally responsible. … Communication and education must be clear, consistent, and easy to access.

Centers of Value

The second platform for reform helps people find the best providers. That means identifying and promotion what Serigraph calls “Centers of Value,” where value means the best combination of service, quality, and price. … Most Americans have almost no idea whether their doctor or hospital system is good, bad, or average for performance. The information has been nearly impossible to track. In contrast, Serigraph makes available to its co-workers the quality ratings that are available. The performance variation is huge.

Prime Role for Primary Care

The third reform platform is a model that centers on primary care, a little like it was in the good old days when doctors and patients had a personal relationship, both for care and for the economics of care. … A large swath of costs can be cut by re-establishing the role of primary care. Big, complex medical systems have homed in on the higher reimbursements offered by the government and insurance companies for specialty care. They put high-priced specialists at center stage. … As a business strategy, the big corporations have hired or acquired primary care physicians to feed patients upstream to their monstrously expensive specialty units.

 

 

Chapter 1: Rampant Health Costs Can Be Controlled

We tried all the obvious tactics to lower health costs. Those included a wellness and fitness program; an annual quoting and bidding process to land a percentage point or two more in discounts from health providers; some rationing (only one Viagra pill per week, for example), and a standard plan that shifted some costs to co-workers with a deductible of $300 and a 20 percent co-insurance. These anemic attempts throughout the 1990s may have mitigated the rate of increase, but at the end of each year, we still showed staggering cost hikes. … Trying to use our buying power against the larger selling power of increasing consolidated providers did not work.

 

Chapter 2: Get Employees’ Heads in the Game

Classic story: 45 minute procedure would cost $8,900. Employee shopped around and found the same procedure for $1,130. Serigraph shares a 75/25 cost with an employee pool. Premiums have been reduced by $1250 per person.

What we have learned is that the winning formula for moderating health cost inflation comes down to:

  • Behavior change by individually responsible users of health care;
  • Aggressive and intelligent management by the company;
  • Creation of marketplace dynamics to help people find good value; and
  • Keeping people out of hospitals.

Health cost savings is not about saving a couple points on the hyper-inflated annual bidding process.

We have learned that keeping costs in check is all about behavior change. That is where the savings lie. Specifically, employees need to be asked to change five behaviors:

  • How they utilize medical services;
  • How they buy healthcare;
  • How they live their lives in terms of personal health;
  • How they follow regimens if they have a chronic disease; and
  • How they relate to their doctors

Prescription: Go to a consumer-driven high-deductible plan, offset by personal health accounts. Those plans unequivocally have been proven to work. Dump plans with no or low incentives and no disincentives.

 

Chapter 3: Utilization Drops Sharply with Individual Responsibility

HRA = Health Reimbursement Account.
Company has a pool of money for employees to draw from. Company reimburses pool (pre-tax) when it’s drawn against.

HSA = Health Savings Account.
Each individual has a tax-free savings account that grows as monthly (pre-tax) deposits are made by the company. Funds are tax-free to remove if used for medical purposes.

Example: Standard state employee coverage = $19,000 per year vs. $1,500 deductible and a $3000 HAS = $12,000 per year

Most co-workers come to think of the health plan as their plan. They own it, at least part of it. And they start to view their health as a personal asset.

 

Chapter 4: Piercing the Fog of Medical Pricing and Promoting Transparency

Use transparency sites to understand and compare the true cost of a procedure.

  • Doctor fees are included with hospital and clinic charges
  • Other line items that were unbundled before, such as anesthesiology, are included
  • Prices are shown for whole episodes of care, from beginning of treatment to the end, including physical therapy after surgery
  • Information on quality is added to identify what we call high-value providers. Some call them centers of excellence; we call them “Centers of Value.” We steer our co-workers to those winners.

Another part of the pricing opacity is overbilling. It is systemic.

Anthem now publicly lists almost fifty procedures with bundled prices, including doctors charges. Humana has a similar site for one of its networks.

 

Chapter 5: Motivate Employees to Seek Centers of Value

Most health plans, including high-deductible plans like ours, have a large flaw when it comes to major procedures. It’s the out-of-pocket maximum for co-workers. Once a person hits $6,000 in out-of-pocket costs, Serigraph steps in to cover 100 percent of the remaining charges. It’s back to free lunch and no consumer discipline.

We decided to use the carrot approach: cash rewards if co-workers would go to the three or four providers we had selected as offering good quality, excellent service, and low prices.

Example: “MedSave Program” company splits the difference of the money saved for an elective knee surgery. $4000 saved by shopping around; $2000 for company, $2000 for employee.

One of the major hurdles for moving business is that patients are used to following doctors’ orders. That makes some sense on purely medical issues, because the doctor is an expert. But doctors don’t usually place business for best price or value. They almost always assign patients to the systems that employ them, regardless of price.

Consumers have the right to buy their healthcare where they choose. And the prices for health care have gotten so high and so financially painful that many of them have to move their business to save money.

 

Healthcare “Syntopical”: The Company That Solved Healthcare 1 (part 2 of 15)

The Company That Solved Healthcare

by: John Torinus
c: 2010

Pigeonhole: Social Science – Public Administration

Contents

Introduction: Real Reform of Health Care Still to Come (p1-10)

  1. Rampant Health Costs Can Be Controlled (p11-18)
  2. Get Employees’ Heads in the Game (p19-30)
  3. Utilization Drops Sharply with Individual Responsibility (p31-42)
  4. Piercing the Fog of Medical Pricing and Promoting Transparency (p43-58)
  5. Motivate Employees to Seek Centers of Value (p59-82)
  6. The Missing Link: Top Management as Change Agents (p83-92)
  7. Beer, Brats, Butterfat: Health, Lifestyle Can Be Managed (p93-110)
  8. Primacy of Primary Care Delivers Big Savings (p111-128)
  9. Quality Ratings Elusive, But Essential (p129-140)
  10. To Reform: Educate, Communicate, Hyper-Communicate (p141-158)
  11. Silver Bullet for Better Value: Lean Disciplines That Transform (p159-172)
  12. Generics, Loss Leaders Provide Leverage on Drug Costs (p173-184)
  13. Better Model for Desperate Small Companies (p185-194)
  14. Private Sector Reforms Trump Government Efforts (p195-206)

Appendix: 2010 Benefits at a Glance (p207-208)
About Serigraph (p209)

 

Healthcare “Syntopical” (part 1 of 15)

A “Syntopical” reading of the subject of healthcare means reviewing a category of books simultaneously, and extracting the key points from each, comparing and contrasting those points, and deriving a conclusion to the questions you had on the topic as a whole.

This review includes four books:

The Company That Solved Health Care
by: John Torinus

The Grassroots Health Care Revolution
by: John Torinus

The CEO’s Guide to Restoring the American Dream
by Dave Chase

Cracking Health Costs
by Tom Emerick and Al Lewis

The take on these four books is that the traditional healthcare system is broken, and there is a better way for companies to implement a program for their employees. Some of the thoughts and ideas come from the era before the Affordable Care Act (ACA / ObamaCare), but the approach and supporting methods have accelerated since the passing of that bill.

The main idea is that a Health Exchange that provides coverage for all individuals, regardless of health conditions, disproportionately benefits those with poor health conditions and burdens those with good health conditions. The idea is that companies can promote good health (sometimes called Wellness or Well-Being) for their employees, as well as adopting a consumer mindset that looks for high quality work at a reasonable price, thus reducing the utilization of overpriced and unlimited healthcare options, which will reduce the expense of healthcare on the employer.

In essence, the books above details ways for a company to move out of a high cost, low value program into a market driven (capitalistic) program in which the price and availability of products are based on quality and demand.

It is the intent of these authors to usher a new wave of healthcare, and the details illustrated in this Syntopical appear to be their first steps in a grassroots effort to fix healthcare.

High Performance Habits: The #1 Thing 2 (part 22 of 22)

Practice #3: Enjoy Connecting

Simply put, high performers have learn the tremendous value in relating with others. They’ve discovered that it is by connecting with others that they learn more about themselves and the world. It’s their connection with others that inspires greater congruence and competence. You know this, too. The more you work with others, the more you learn new ways of thinking, new skills, new ways of serving. That hit of learning is what high performers told me gives them so much drive to engage.

This is an important distinction, especially if you don’t consider yourself a “people person.” It doesn’t matter whether you are natural with others. What matters is this: “Do you want to learn from others? Will you take the time to do it? Will you genuinely try to engage someone and learn about how they think, what they need, what they stand for?” If you can summon that curiosity and talk to enough people with that intention, you will gain confidence. At least, that’s what high performers have shared with us.

High performers’ confidence, then, comes from a mindset that says, “I know I’ll do well with others because I’ll be genuinely interested in them because I want to learn.” In my interviews, no one said the opposite: “I know I’ll do well with others because I’ll make them genuinely interested in me, because I want to teach them who I am.” They are not thinking about their “elevator pitch” or what they have to tell everyone as much as about what they might learn or how they can serve. Confidence comes less from projection than from connection.

PERFORMANCE PROMPTS

  1. The main reason I want to become better with people is …
  2. I know I’ll become more confident with people when I …
  3. To gain more confidence with people, from now on when I talk with them, I’ll think to myself …

 

A Formula and Farewell for Now

As you reflect these three confidence builders – competence, congruence, and connection – perhaps you’ve noticed an underlying theme. What drove the development for high performers in each of these areas was curiosity. It was curiosity that developed their knowledge, skills and abilities. Curiosity drove their self-examination. You have to ask a lot of questions of yourself to see whether you’re living a congruent life. Curiosity made them want to seek out others. Perhaps, then, there is a formula at play:

Curiosity x (Competence + Congruence + Connection) = Confidence

The promise of this equation is that you don’t have to pretend to be superhuman. You just have to care enough to learn new things, to live in alignment with who you want to become, and take interest in others. You’ll feel better about yourself, and research shows that curiosity itself can improve your well-being. Curiosity is the electric arc for life bright with joy and vibrancy. To get there, you just have to start conditioning the internal dialogue that says …

  • I know what to do and how to add value here (or at least I believe in my ability to figure things out and I’m willing to go for it)
  • I know I’m living in alignment with the person I want to become.
  • I know I’ll do well with others, because I’m genuinely interested in learning about them and serving them. 

I don’t pretend that becoming more confident or reaching high performance will be easy. Throughout this book, I’ve shared that the journey to becoming more extraordinary in life will always be brought with struggle. But as I’ve also shared, ease is not the objective in personal development; growth is. So anticipate and honor the fact that it’s going to be difficult to implement the habits and practices of this book.

  1. Seek Clarity on who you want to be, how you want to interact with others, and what will bring meaning into your life.
  2. Generate Energy so you can sustain focus, effort, and well-being. To stay on your A game, you’ll need to care actively for your mental stamina, physical energy, and positive emotions.
  3. Raise the Necessity of your level of performance. This means actively tapping into the reasons you must perform well, based on a mix of your internal standards (e.g., your identity, beliefs, values, or expectations for excellence) and external demands (e.g. social obligations, competition, public commitments).
  4. Increase Productivity in our primary field of interest. Specifically, you’ll need to focus on “prolific quality output” (PQO) in the area in which you want to be know and to drive impact. You’ll also have to minimize distractions (or opportunities) that steal your attention from creating PQO.
  5. Develop Influence with those around you so you can get them to believe in and support your efforts and ambitions. Without a positive support network, major achievements over the long haul are all but impossible.
  6. Demonstrate Courage by expressing your ideas, taking bold action, and standing up for yourself and others even in the face of fear, uncertainty, or changing conditions.

Seek clarity. Generate energy. Raise necessity. Increase productivity. Develop influence. Demonstrate courage. These are the six habits that you need to adopt to reach high performance and stay there. These are the habits that will make you more confident in life and even more extraordinary.

From now on, before every meeting you go into, before every phone call, before you start any new project or pursue any new goal, revisit the six habits.

I hope you wake up each day and decide to practice the habits that will make you proud of your life. I hope that as you endeavor to live an extraordinary life, you bring the joy and honor the struggle and seek to serve others. I hope that as you look back one day, having reached a level of performance you could never have dreamed of, you can say that you wanted it, you worked for it, you willed it to happen – that you never gave up and you never will. You became extraordinary because you chose to.

That reality, I believe, is something available to each of us. Now go earn it. 

High Performance Habits: The #1 Thing 1 (part 21 of 22)

We’ve measured over a hundred variables in search of which habits matter most in high performance. We’ve asked high performers almost every conceivable questions bout how they got so extraordinary. We’ve also sought to find out what matters most in the increasing overall HPI scores and scores in each habit area proven to correlate with high performance. And so far nothing we’ve found correlates with high performance scores across the board more than confidence. Confidence is the secret ingredient that makes you rise to the challenge.

But this doesn’t mean confidence alone causes high performance. You can have all the self-confidence in the world, but if you don’t practice the high performance habits, the odds of long-term success aren’t so good. It’s clear from our research that to become extraordinary, you need strong confidence and high performance habits.

But where does the kind of confidence that improves performance come from? What, specifically, do high performers do to gain and maintain confidence as they deal with life’s challenges and take on ever greater goals?

The 3 C’s of Confidence

High performers do have more confidence than most people, but not by birthright, luck, or superhuman skill. What I found was that high performers simply thought about things that gave them more confidence than others, more often did things that gave them more confidence than others, and avoided things that drain confidence more often than others did, They almost universally reported that their confidence came from purposeful thinking and action.

Practice #1: Develop Competence

While most people think of confidence as a general belief in oneself, the kind of confidence that it most tied to performance improvement comes from belief in one’s abilities in a specific task. This means that the more knowledge, skill, ability, or talent – that is, competence – you have at a given task, the more likely you are to be confident and perform well. I’ve been teaching about this “confidence-competence loop” since 1997, and I’m continually surprised at how much it comes up in conversations with high performers.

The idea here is that the more competence you get at any given task, the more confident you’ll become in trying it more often – and the more you’ll stretch yourself. That repetition and stretching leads to more learning, which gives you more competence. More competence, then, begets more confidence, and round and round it goes.

In the chapter on productivity, I covered how to get super-competent at any skill through practicing progressive mastery. So let me move on to another distinction in this area. High performers have confidence not only because of past skill acquired in a specific area, but equally from trust in their ability to gain future competence. That is, they reported that their confidence was not tied to one specific competency but rather to a belief that they could adequately handle things in the future – even if they had no experience. Their confidence came from belief in their power of learning in general.

High performers are learners, and their belief that they can learn what is necessary to win in the future gives them as much confidence as their current skill sets. 

Having learned so many things in the past, they trust they can do it again. In this way, it became clear that the internal voice of a higher performer is saying, “I believe in my ability to figure things out.” It’s a bit circular but no less true: The key competency that gives high performers confidence is the ability to quickly gain understanding or skill in new situations. In other words, the competency that matters is the ability to become competent.

High performers ponder the lessons from their wins. They give credit to themselves, and they allow those wins to integrate into their psyche and give them greater strength. 

That’s what, as you strive, it’s important that you begin a practice of reflecting on your progress and your new learning. Don’t wait until New Year’s Eve to think about all the great things you did and learned this year. I recommend you spend at least thirty minutes every Sunday reflecting on the previous week. What did you learn? What did you handle well? What do you deserve to give yourself a pat on the back for? As simplistic as this may sound, it can have a profound effect in helping you gain more confidence.

PERFORMANCE PROMPTS

  1. The competences – knowledge, skills, abilities, or talents – that I have worked hard to cultivate in my life include …
  2. If I gave myself credit for learning all those things, I would start to feel more …
  3. Something I’ve learned to do in the past few years that I have not yet given myself credit for is …
  4. I feel that I can handle a big challenge in my life right now because I am good at learning how to …
  5. A practice I’ll begin doing every week to help me start feeling more confident is …

 

Practice #2: Be Congruent

It’s hard to be congruent. Naturally, different parts of us are engaged at different times. Our identity, personality, states, and standards may vary from one context to the next. We might be a rock star at work but a janitor at home. We may be fun, exciting, and playful with our best friends but shy and reserved in bed. We can be aggressive in one situation, then fail to be assertive when it counts. Variance in who we are in any given context is natural and, despite what some would have you believe, healthy. Life we be terribly unhealthy (not to mention boring) if we were exactly the same all the time.

To feel more congruent, though, we will have to be more conscious about who we are and what kind of life we want to live. We will have to be conscious in crafting and maintaining our identity.

All this requires conscious choice and work. Maybe someone didn’t light the candle of love for you when you were younger, so your’e always had the identity of someone who isn’t or could not be loved. Now, as an adult, you can consciously choose to light that candle for yourself. Perhaps you were never given the attention or respect you desired. Now is the time to give it to yourself. Maybe no one every instilled in you the confidence that made you feel you could shape or shake the world with your power. Give that confidence to yourself. This is the path to constructing your own identity.

They shaped their identity by conscious will and have aligned their thoughts, feelings, and behaviors to support that identity. 

The more days they live in congruence with who they have chosen to become, the more they feel a sense of general confidence in life. I heard it over an dover again in interviews: “I decided to break free from my parents {or my job or my old relationships} and do what I really wanted to do.” “I finally chose to seek work that was more me.” ” I started living with greater intention.”

If you can understand the power of congruence, then you can understand why the habit of seeking clarity is so important to confidence. You can’t be congruent with something you’ve never defined. No clarity, no congruence, no confidence. It’s that simple. That’s why I encourage you to revisit the chapter on clarity and remember to fill out the Clarity Chart each week. Enter each week with intention for who you want to be, then align your actions with that self-image, and you’ll gain greater confidence.

PERFORMANCE PROMPTS

  1. The person I really want to be in life could be described as …
  2. Three things I could do each week is live more congruently with that vision for myself include …
  3. Three things I should definitely stop doing in my life so I can live in greater congruence with my ideal image of myself are …

High Performance Habits: Beware Three Traps 3 (part 20 of 22)

Overreaching

Now you have a new tool to avoid becoming oblivious as you continue to rise. The next issue, overreaching, is a little trickier to deal with.

According to the high performers who failed to maintain their success, overreaching was a problem that stemmed from an insatiable desire for more, couple with an unrealistic sense of what is possible in a short time frame, which led to overcommitment. In other words, it was an issue of going for too much, too fast, in too many domains.

Their lesson learned was clear. When you’re good, you want to take on more. But beware the impulse. High performance isn’t about more for the sake of more, just because you can. It’s often about less – zeroing in on just those few things that matter and protecting your time and well-being so you can truly engage those around you, enjoy your craft, and confidently handle your responsibilities. Focus on just a few things and the people and priorities yo really care about, and you won’t fall prey to overreaching. Broaden your ambitions too widely, and your appetite soon outstrips your abilities. Hence the importance of reminding yourself that the main thing is to keep the main thing the main thing.

Slow down, be more strategic, and say no more often. … So what, exactly do we mean by “slow down”? First, rather than live a reactive lifestyle, you take ownership of your day. When the successes pile up, it’s easy to spend time responding to invitations and calls and well-wishers’ requests. Suddenly, the day has cruised by and you haven’t done anything. You feel successful, but nothing is really happening except new meetings. Slowing down means taking the time to care about your schedule – doing what you’ve learned in this book about reviewing your calendar and to-dos each night, each morning, each week.

It also means saying no to the good things that would stretch your day too far. if a good opportunity comes up but it’s going to rob you of a few nights’ sleep, force you to cancel strategic moves you planned long ago, or knock you out of time with your family, then just say no. Cramming your day so full that you have no time for thought or rejuvenation just makes you tired and irritable. And no one credits fatigue and a bad mood for their world-class performance.

To help you discern between the yeses an dos, you have to start thinking more strategically. Strategic thinking means stripping things down to the essentials and planning their accomplishment out over months and years. This is hard, but you have to weigh opportunities differently now, measuring them against a much longer horizon. You can’t think just about how flashy something is this month. You have to be executing against a plan – your five moves – that’s already in place for the next several months. If the new thing you want to commit to doesn’t strategically move you toward your end goals, it must be delayed. Most opportunities in life that are really worthwhile and meaningful will still be here six months from now. If that’s hard to believe, it’s just because you’re new to success. So slow down; say no more often; be more strategic. Don’t let obliviousness to what really matters, or reaching for what doesn’t, slow down all your hard-won momentum.

Don’t forget what got you here … One last simple reminder: Don’t forget the positive habits that brought you to this level of success, and do not neglect the habits that you now know will take you to the next level.

PERFORMANCE PROMPTS

  1. An area where I am neglecting someone or something important in my life is …
  2. An area where that neglect will cause me regret later on is …
  3. An area where I can now return my focus, reallocating my attention to things that matter, is …
  4. Some areas in my life where I feel overcommitted right now are …
  5. The things I need to learn to say no to more often are …
  6. An opportunity I really want to chase right now that I could schedule to revisit in a few months is …
  7. The main things moving the needle toward my success that I should be focused on right now, despite all the other exciting interests and opportunities I could chase, are …
  8. The way I’ll remind myself not to take on too much is …

Tough Truths

The culprits tha steal your success are not lack of values or intelligence. The culprits are ultimately allocations of attention. You feel separate from others, so you stop paying attention to feedback, diverse viewpoints, new was of doing things. You get so good that you start noticing only what’s wrong, and a constant state of disappointment drains your passion. You rationalize neglecting one area of life so you can get ahead, saying it will be “worth it,” so you stop focusing on what really matters in life.

None of these things has to be your reality

Superiority, dissatisfaction, and neglect are your enemies. Let them invade your life, and you lose. Be vigilant, avoid them, and practice your HP6, and all will be well.

It’s always a difficult truth when we notice ourselves behaving in the negative ways we’ve discussed in this chapter. But if sustaining success is important to you, I encourage you to revisit this chapter often. It will keep you humble, satisfied, and focused. And it will allow you and others to enjoy what should be an extraordinary life and a joyous ascent to high performance.

High Performance Habits: Beware Three Traps 2 (part 19 of 22)

Trap #2: Dissatisfaction

Those who are never satisfied are never at peace. They can’t tune in to their zone – the noise of a dissatisfied mind prevents them from finding a rhythm that makes them feel alive and effective.

Ultimately, the dark, exhausting, negative emotional prison that is constant dissatisfaction saps performance. Perennial dissatisfaction is the first step on the path to misery.

If dissatisfaction is so detrimental to performance, why do so many people think you have to be dissatisfied to succeed? Because it feels natural and automatic. It’s easy to be dissatisfied, because noticing what’s wrong in a situation is a habit of evolution.

The reason I push so hard against the “never be satisfied” credo extends beyond the empirical research. Simply, this thinking has little to no practical value, because the emphasis is in the wrong area. It’s pointing in a statement rather than a positive direction. When you speak to people who are fond of that instruction, and ask them to turn it into a positive takeaway, they say such things as “Stay motivated”; “Notice what’s not working and improve it”; “Care about perfecting the details”; “Set your sights on bigger goals as you grow”; “Keep moving forward.” The truth is, you can do all these things and still be satisfied. Seeking excellence and experiencing satisfaction are not mutually exclusive.

Being satisfied, then, doesn’t mean “settling.” It simply means accepting and taking pleasure in what is.

So how can you avoid performance-sapping dissatisfaction? I suggest a big-picture reminder: Life is short, so decide to enjoy it. Instead of discontent, bring joy and honor to what you do. I promise you’ll start feeling more alive, motivated, and fulfilled.

In this moment now, you can breathe deep and finally, after all this time, give yourself love and appreciation. To help you on this journey, try this:

  • Start journaling at the end of each day. Write down three things that went well or better than expected that day. Write about any progress or blessings that you feel grateful for. It’s such simple but essential advice to keep a high performer performing high: Start noticing what’s going well, appreciate your blessings, enjoy the journey, and record your wins.
  • Get your family or team together once a week for no other reason than to talk about what’s working, what are people excited about, what difference your efforts are making in real people’s lives.
  • Start meetings by asking others to share one great thing that has happened that can give the team a sense of joy, pride, and fulfillment.

These are simple steps, but they will matter to the people you love and lead.

PERFORMANCE PROMPTS

  1. The areas of my life I’ve felt consistently dissatisfied with include …
  2. Some good things that have also happened in those areas include …
  3. Something I can say to myself the next time I feel dissatisfied, to get me to notice the good things and continue moving forward, is …
  4. Someone who probably sees me dissatisfied more than I want them to is …
  5. If I were going to inspire that person to believe you can enjoy life as you work hard and succeed, I would have to change these behaviors …

 

Trap #3: Neglect

Neglect, like the other traps of superiority and disappointment, sneaks up on you. You don’t say to yourself, “I’m going to neglect my health, my family, my team, my responsibilities, my real passions and dreams.” It’s more that passion or busyness blinds you to what’s important, just long enough for things to fall apart.

Often, then, it’s not what you do that unseats you from high performance, but was you don’t do. In single-minded pursuit of achievement and mastery in one area of life, you take your eyes off the other areas. Soon, those areas fight back for more attention. This si the story of those who work so hard in their career that they keep forging their spouse’s needs. Soon, the marriage is in turmoil, the high performer feels awful, and performance declines. Switch this example out with neglect of one’s health, children, friendships, spirituality, or finances, and you still have the same story: Obsession in one area of life hurts another area, setting off a negative cascade of events and feelings that eventually unseats the high performer.

I want you to avoid this fate. The good news is, it’s tactically easy to avoid neglect. The bad news is, it requires  difficult and often dramatic mental shift. Before I share the how part, let me share two distinctions about why high performers neglect something important to them in the first place.

Obliviousness

Obliviousness is the less used excuse of the two, but a destructive culprit nonetheless. It means you are so focused in one area that you are completely unaware of the growing problems in another. High performers who started losing explain it by saying, “I was so obsessed with work, I honestly didn’t realize I was getting so fat.” Or “She just up and left one day. I was blindsided and hated myself for it.” Or “That’s when I realized my team had been telling me the same things for months, but I was too busy to pay attention.”

Part of the reason it’s so painful is that the things that they believe help the climb to success – hard work, focus, and persistence – became the very things that caused their demise.

The chapters on clarity and influence will help you avoid obliviousness. Also, you might want to recall and implement the life arenas activity from the chapter on productivity:

The solution is to keep perspective in life by keeping an eye on the quality or progress of the major life arenas. A simple weekly review of what we’re after in the major areas of our life helps us rebalance or at least plan for more balance.

I’ve found it useful to organize life into ten distinct categories: health, family, friends, intimate relationship, mission/work, finances, adventure, hobby, spirituality, and emotion. When I’m working with clients, I often have them rate their happiness on a scale of 1 through 10 and also write their goals in each of these ten arenas every Sunday night.

 

High Performance Habits: Beware Three Traps 1 (part 18 of 22)

BEWARE THREE TRAPS

BEWARE SUPERIORITY
BEWARE DISSATISFACTION
BEWARE NEGLECT

This is a chapter about failure. But not just any kind of failure. It’s about the calamitous fall from grace that high performers can experience when they get so good that they forgot what made them successful.

  1. When high performers fall from grace, the most frequent culprits (aside from failing to practice the habits you’ve learned in this book) came down to three things.
  2. When high performers rose back up, the habits in this book were the vehicle for that ascension.
  3. When high performers describe such an up-and-down journey, they clearly never want to make the same mistakes again. The fall was that painful. When you fail at the beginning of journey, it’s frustrating. When you fail hard after making it for so many years, it feels immeasurably worse.

So what were the three things that caused high performers to fall out of prolonged success? Let’s start with what didn’t cause them to fail:

  • Fear was not the issue.
  • Competence was not an issue.
  • Other people were not the issue.
  • Creativity was not the issue.
  • Motivation was not the issue.
  • Resources were not the issue. 

These issues could certainly be fair and understandable reasons for people to fail. But what I’ve learned from high performers is that these just aren’t the real failure points of sustained performance. The real traps are internal – negative patterns of thinking, feeling, and behaving that slowly kill our humanity, zest, and well-being. The traps are superiority, dissatisfaction, and neglect.

 

Trap #1: Superiority

High performers face a unique set of character traps because they are, by definition, outperforming so many around them. When you are succeeding beyond others, it’s easy to get a big head. You can begin to think you’re special, separate from, better than, or more important than other people. … This is a way of thinking that you must avoid at all costs.

Here’s how to know when superiority has infiltrated you mind:

  1. You think you are better than another person or group.
  2. You’re so amazingly good at what you do that you don’t feel you need feedback, guidance, diverse viewpoints, or support.
  3. You feel that you automatically deserve people’s admiration or compliance because of who you are, what position you hold, or what you’ve accomplished.
  4. You feel that people don’t understand you, so all those fights and failures are surely not your fault – it’s that “they” just can’t appreciate your situation or the demands, obligations, or opportunities you have to sort through daily.

When any of these realities is a constant in your life, you’ve begun the decline, even if you don’t know it yet. What these thoughts have in common is a sense of separateness. You just feel so much more capable or accomplished than others that, in your mind, there is you at the top and then everyone else.

When we’re facing any of these difficulties, it’s easy to feel that were’ the only one going through the struggle. But that feeling is pure illusion. There is no human emotion or situation you are counting with that someone, somewhere, cannot understand if you are vulnerable and real an open enough to share your thoughts, feelings, and challenges. Yes, you can keep telling yourself that your spouse can’t possibly understand, and if you never try, that will be self-fulfilling prophecy. … Their lack of understanding only grows in your silence.

A few more points about the lonely-at-the-top syndrome, just because it’s just so corrosive:

First, I’ve rarely met a high performer who thinks they’re “at the top.” Most feel like you’re just getting started. … They understand they’re still students of life, and no matter how stellar their success, they feel that they’re just a few steps in on the path of mastery. This is a widely held attitude with the top scorers of our assessments whom I interviewed.

Second, here’s a special reminder if you have begun dismissing other people’s capabilities. You can’t maximize your potential while minimizing others. What you have attained in life isn’t because your’e all that special, but because you’re all that blessed. The reality is that a large part of the differentiation in performance at you level comes down to the habits we’ve discussed – which anyone can begin implementing – augmented by exposure, training, practice, and access to excellence-driven mentors, coaches, or role models. That’s why I often have to remind the superior minded: You are not better than anyone. You likely got more exposure to your topic; you had more information or opportunity available to you; you got trained better; you had the opportunity to put in more passion or deliberate practice over more time; you had the opportunity to receive good feedback and guidance. These things are not inherent to who you are. These things, if given to anther person, would help them rise to your level. True? (If you don’t answer yes, please shake hands with your ego.)

This warrants the simplest of remedies: Don’t just others as below you or separate from you. Your frustration with people is coming from a forgetfulness that almost everyone could succeed at a higher level if they had more exposure, training, practice, and access to excellence-driven mentors, coaches, or role models. Remember, everything is trainable. That doesn’t mean everyone will request the training, put in the hard work, reach number one, or have as much grit as you. But everyone is capable of success. Everyone can win at life. So let’s be honest: You were once a mess, too, or did you forget already? But you improved. Give others that same opportunity. When you remember that you, too, struggled, and you remind yourself that others can dramatically improve themselves, that’s when you start to be more compassionate. That’s when you start to beat back any hint of a superiority complex.

So what’s the solution? I’ve found that the first step is always awareness. You have to be alert and catch yourself when you start thinking you are separate from tother for any reason. Second, you need to develop habits that will help you stay humble and open even as you get better at what you do.

How do you stay humble? … You begin developing a more open and test-oriented mindset by flipping the earlier examples:

  1. To avoid thinking you’re superior to others, deliberately seek others’ ideas for improving anything you do: If you could improve on my idea, how would you go about it?
  2. If you find that your thinking is not being challenged enough or your growth has topped out, hire a coach, trainer, or therapist.
  3. To avoid thinking you automatically deserve people’s admiration or compliance just because of who you are, where you came from, or what you’ve accomplished, remind yourself that trust is earned through caring for others, not bragging about yourself.
  4. Instead of believing that people don’t understand you and that they are to blame for the fits and failures in your life, take ownership of your actions by reflecting on your role.
  5. Keep a practice for reminding yourself of your blessings.

These suggestions will help keep you humble, effective, and respectful. That’s how you sustain success, and that’s how you build a life you can be proud of.

PERFORMANCE PROMPTS

  1. A recent situation where I found myself being overly critical or dismissive of others was …
  2. The thoughts I had about myself in that situation and others involved were …
  3. Had I reimagined the situation from a more humble and appreciative view, I would probably have realized that …
  4. The best way I can remind myself that everyone is dealing with difficulties in life and that we’re all more alike than we are different is …

High Performance Habits: #6 Demonstrate Courage 3 (part 17 of 22)

Practice Three: Find Someone to Fight For

We will do more for others than for ourselves. And in doing something for others, we find our reason for courage, and our cause for focus and excellence.

Each of the highest performing people I interviewed told me about someone who inspired him to excel. They all had a reason, and that reason was often a person, not always a purpose or a group of people. Most often, just one person. Sometimes, it was more than one: their kids, their employees, their extended family, their community’s need. But more often than not, it was just one. 

Sometimes, courage appears to be a spontaneous act. But what I have found is that it’s usually an expression or action built up from years of caring deeply about something or someone. So begin seeking things and people you care about. Give. Care deeply about something now. Stand up for something now. And then you will be more likely to find courage when it matters.

PERFORMANCE PROMPTS

  1. A courageous action I will take this week because someone I love needs me to take it is …
  2. Another courageous action I will take this week, because a cause I believe in needs me to take it, is …
  3. Another courageous action I will take this week, because my dream requires it of me, is …

 

Courage Through Complexity

Just as the universe doesn’t become less complex, life doesn’t tend to get easier. But you get stronger. You learn to show up more, cope better, and be truer and more conscious amid the judgement and hardship. Soon, the obstacles do begin to seem smaller and the path seems more your own. So no matter what happens, trust in yourself and lean forward. The next level opens after your next courageous step.

And here’s what I’ve learned: For most people, courageous acts are indeed rare events. But we remember those acts, and they shape our sense of ourselves and our lives as much as the small stuff. And so I ask you to consider the questions below often, to ready your mind for even more courage. Only by conditioning ourselves now will we truly serve with grace and courage when called.

  • What in my personal life have I avoided doing, which might involve hardship but just might improve my family’s lives forever?
  • What could I do at work that would require stepping out on a limb but would also truly change things for the better and help people?
  • What decision could I make that would demonstrate a moral commitment to something higher than myself?
  • How could I bring myself to face a situation that usually makes me nervous or anxious?
  • What change could I make that scare me but will help someone I love?
  • What good thing could I walk away from to advance my life?
  • What have I wanted to say to those close to me, and when and how will I courageously declare that truth?
  • Who needs me, and who will I fight for the rest of this year?

These questions might spur some brave thinking and action today. Ask them enough, and practice the habits in this chapter, and you’ll come to this truth: Deep down, away from all the noise, where love blankets your heart and your dreams lie in wait, you are not afraid.

High Performance Habits: #6 Demonstrate Courage 2 (part 16 of 22)

Practice Two: Share Your Truth and Ambitions

In The Motivation Manifesto, I argued that it is the main motivation of humankind to be free, to express our true selves and pursue our dreams without restriction – to experience what my be called personal freedom. Our spirits share when we feel unencumbered by fear or the weight of conformity. When we live our truth – expressing who we really are, how we really feel, what we really desire and dream of – then we are authentic; we are free. This requires courage.

But for anyone who doubts or diminishes you, forget about it. Don’t bother trying to please them. Live a life that is yours. Don’t seek the approval of the doubters. You’ll find no lasting joy in seeking acknowledgement from others. If it comes, it’ll never be enough. So the only path left is to express your own truth and pursue your own dreams.

Minimizing Ourselves

One thing I didn’t expect from readers of The Motivation Manifesto was a different kind of fear in sharing their truth. Many people wrote in and said they weren’t worried that others would judge them as insufficient; they were worried that by being their best, they would make others feel insufficient. They were fearful of expressing their true ambitions, joy, and powers, because the people around them could feel bad about themselves.

They felt they had to minimize their dreams, keep their big ideas bottled up, dumb themselves down, tone it down, look down – all so others could feel good about themselves.

So please stay with me. I have no doubt that accessing the next level of courage in your life requires a new degree of openness and honesty about who you are, what you want, and what you’re really capable of and ready to do. All that stands in your way is that fearful part of you that feels like minimizing yourself so that you don’t make others feel bad. But don’t for one minute think that’s humility. That’s lying about your real ambitions. That’s apologizing for the gifts that God, the universe, fortune, or hard work – take your pick – blessed you with. And it’s insidious. Unless you choose to let it go, that fear will forever prevent you from feeling truly authentic and fulfilled and living out your real potential. It will drive you to lower your sights and miss out on excellence – and for what, exactly?

You may think, People will be threatened by my drive and desire. They might not like my ambitions. They might make fun of me. So I’d best keep quiet. It’s better to downgrade my ambition or work ethic, anyway.

I’ve heard every version and permutation of that misbegotten idea. But I want to say it again and etch it on your mind: This kind of thinking is not humility, my friend. It’s fear. It’s lying. It’s suppressing. It’s adolescent concern. And it will destroy any real aliveness and authenticity in your relationships. I know, it may feel better in the short term to minimize yourself so someone else can feel good about themselves, but consider this: No one wants to be in connection with a fake person. 

Look. If you’re gulping back your real thoughts and dreams just to “fit in” or make others feel better, then you can’t blame them or anyone else. Because it’s you choking yourself. And while you’re at it, you’re squeezing the life out of your relationships.

No one can quiet you without your permission. No one can minimize your self-image but you. And no one can up you up and release your full power but you.

You can always blame “them” for your failure to be real and vulnerable. Or you can choose this very day to start speaking up and living in full, even though some may not like it. Will some people make fun of you? Might a person you love doubt you ar leave you? Could your teammates call you crazy and marginalize you? Can your neighbors or fans turn on you for wanting “more than you deserve?” To each of these questions, yes. But which is nobler: falling dutifully in line with what everyone wants, or speaking up for what’s right for you? Ultimately, you must ask which your life is about: fear or freedom? One choice is the cage. The other – that’s courage.

I see this all the time. A successful person fails to achieve the next level of success because they chose to strive in silence. They don’t want to share or speak up. They’re trying to be “appropriate,” “realistic,” “level-headed.” They’re trying to make others “happy” or “comfortable.” And so they have these brilliant ideas, and not only do they not share them, they make the most lethal mistake of all: They don’t ask for help. If you don’t ask for help, the right people can’t come into your life. So if the universe isn’t giving you was you want, perhaps it’s because amid all your distractions and silence, the universe just doesn’t know what you’re asking for.

The people who are in your life for the right reasons will list to your truth. They’ll applaud your ambition. They’ll be happy to meet the person behind the face. They’ll thank you for sharing, for being real, for trusting them. Trust others with your truth, and the golden values of real friendship and love reveal themselves like lost treasures.

To find even more courage, remind yourself that you owe it to those who have supported you in the past. Stay strong in recognition of the strength they have given you. As a gift to all those who have been good to you, don’t complain; act. Don’t criticize; cheerlead. Don’t conform; live your truth. Don’t be selfish; serve. Don’t take the easy path; strive for growth and an extraordinary life.

The Simple Conversations

The most important thing in connecting authentically with others is to share your true desires with them. They don’t have to approve or help or even brainstorm with you. This isn’t about them. This is about you having the courage to open to others just as the universe remains open to you. Try it. Each day, reveal to others a little bit more of what you’re thinking, feeling, dreaming of. Even if you don’t get the immediate support of the humans in front of you, who knows? Perhaps a distant force is unlocked and the necessary ripples in time and luck and destiny converge and deliver to your door a hint about the next step – a treasure map of sorts, unearthed by your own courage.

This habit doesn’t take shape by a single momentous conversation with everyone you know. You don’t have to sit everyone you love down and tell them all the reasons you’ve been holding back from them and from life. You don’t have to shoot a video explaining your entire life and philosophy. Instead, just make it daily practice to be sharing your thoughts and goals and feelings with others. Every day, share something with someone about what you really think and want in life. You could say “You know, honey, today I was thinking about starting X because I’d love to Y.” for example:

  • I was thinking about researching how to write a book, because I think I have a story worth telling.
  • I was thinking about starting to hit the gym every morning, because I’d love to feel more vital and alive.
  • I was thinking about starting to look for another job, because I’d love to feel more passionate and appreciated.
  • I was thinking about starting to cold-call some new coaches, because I’m ready to compete at a higher level.

These are simple statements. It’s a simple formula. What do you want to share? Whatever it is, share it. Then take bold action each day to bring it to reality.

PERFORMANCE PROMPTS

  1. Something I really want todo that I haven’t shared with enough people is …
  2. If I were going to be more “me” in my everyday life, I would start to …
  3. When I put myself out there and someone makes fun of me, I’m just going to …
  4. A major dream I’m going to start telling people about and asking for some help with is …