Ethics in Healthcare: Not Just For Everyone Else

07/10/2007

Many people become skeptical when they hear CEOs talk about ethics. Some assume that business and ethics don't mix - that a strong bottom line is all that counts. Others believe that CEOs should address ethics only during a crisis, and only then as damage control.

All this reminds me of a memo sent out every fall by a prestigious financial services firm. This firm had some bad negative press about some ethical missteps made by its management. The memo, however, admonishes staff who help themselves to the office supply rooms for pencils, pads, glue, and other items their kids need as they start school. For all the ethical trouble this firm has experienced, notebooks, rulers, and scissors would seem to be the least of their ethical problems.

In her book, Value Shift: Why Companies Must Merge Social and Financial Imperatives to Achieve Superior Performance, Harvard professor Lynn Paine states, "People sometimes forget that business ethics at its core is about excellence and high attainment, rather than misdeeds and malfeasance."

She adds, "In the future, I think more managers will recognize that risk management is only part of the story and that the benefits of positive values go well beyond problem avoidance. More managers are waking up to the ways in which positive values contribute to a company's effective day-to-day functioning, as well as its reputation and long-term stability."

As a senior leader, maintaining high levels of ethical and professional conduct at your healthcare institution is essential. You no doubt periodically reassess your organization's code of ethics, making certain that it reflects the highest standards possible. Because the code is, in many ways, a foundation of your institution, your senior leadership team must be able to effectively communicate those ideals to providers, managers and staff.

Senior healthcare executives recognize that ethical dilemmas occur often. Some issues—such as whether or not the purchasing department should use 'strong-arm' negotiation tactics with suppliers—are easy; the answer is simply "no".

Other issues, however, require more thought and consideration. Take for example a loyal employee whose personal life is in crisis and whose performance has fallen off dramatically. Going by the book, she should be terminated, but you know her well and feel strongly that within a short period of time, she will come through her ordeal and resume her excellent work habits. However, keeping her in her position might negatively impact her co-workers and send the wrong signal to others. You also know she is a single mother of three, which only adds to your dilemma.

One healthcare institution that is doing an especially good job of communicating the importance of high ethical standards is Boston's Beth Israel Deaconess Medical Center. Lisa Zankman, Senior Vice President of Human Resources, noted that Beth Israel maintains an Office of Business Conduct. This group handles annual requests for information, monitors potential conflicts of interest, and takes anonymous and named calls from people who suspect wrongdoing.

The effort seems to be paying off. In a recent employee satisfaction survey, 97% of Beth Israel Deaconess employees answered "yes" when asked: "Does Beth Israel conduct business in an ethical manner?"

According to the American College of Healthcare Executives, "The fundamental objectives of the healthcare management profession are to enhance overall quality of life, dignity and well-being of every individual needing healthcare services; and to create a more equitable, accessible, effective and efficient healthcare system." They add that, "Healthcare executives have an obligation to act in ways that will merit the trust, confidence and respect of healthcare professionals and the general public. Therefore, healthcare executives should lead lives that embody an exemplary system of values and ethics."

The last line above is some of the best advice for those of you who want to encourage members of your leadership team to fully embrace your hospital's code of ethics. Leading by example is the most powerful method by which to influence others. The question becomes how to do that consistently and in a more transparent fashion, so that your team always sees you as the effective and fair leader that you are. Here are a few ideas you might want to try on for size:

Make sure your statements and actions are at all times professional and consistent with your organization's core values. There is nothing more damaging than management saying one thing ("we adhere to our core values") and doing another ("... except for me when I'm in a difficult position"). Because of your position as a leader, your words and actions are always scrutinized, and let's face it, certain individuals always want to see you fall short.

If you find yourself in a situation where you are unable to comment on a sensitive subject, get out of there and say as much. Don't let others assume you are hiding and avoiding an issue ... let people know you will make a statement when it's appropriate.

Never shy away from a discussion involving ethical aspects of a financial or business decision. Here is where the rubber meets the road. You must be able to discuss all sides of an issue with your management team openly and without hesitation.

Speak openly, honestly and often with your team about sensitive issues within the community, such as access to care and ability to pay, domestic violence, substance abuse, etc. Some of the most difficult issues affecting your institution may be a result of what is going on in the community. As a healthcare leader, you must acknowledge those issues and encourage your team to discuss them and look for solutions.

Do not delay in making difficult decisions, and keep senior management apprised and engaged as you find resolution to complex problems. This is not to say that you should sacrifice getting the complete picture before you make a decision, but timeliness is often crucial, and a swift and concise determination creates confidence and trust in your ability to lead. By including your senior team in the information-gathering process and allowing them to contribute their ideas, you foster teamwork and an environment of collaboration.

Communication is key when it comes to ensuring that your institution's ethics and core values are taken seriously, and that as a senior leader, you believe that business and ethics must always co-exist.

Some of our current engagements include:

Leadership Quote of the Month

"You miss 100% of the shots you never take."
~ Wayne Gretsky

 

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