This is a little preface to the insights, musings, rantings, thoughtful review, report I give below. Okay, so being truthful is not always that easy, but—when it comes right down to it—I still tend to agree with Sylvester the Cat:
Dr. Jerk Teaches a Lesson
Maybe I am naïve. I tend to expect everyone I encounter to be honest, up front, ethical. As an educational leader, I value those traits immensely; without them, effective leadership and overall stewardship of programs or institutions cannot take place. Oh, I have been disappointed as colleagues break the rules for their own gain, tell less than the truth about a situation, or do whatever it takes to get what they want even if that means bending the rules or ignoring what’s right. But I still expect people to be up front and ethical, at least until they prove otherwise.
Last week I was forced to deal with someone who was not living up to my expectations that people are basically honest. To make matters worse, it was a doctor. I don’t know why, but I expect even more from other professionals, especially doctors. Aren’t doctors supposed to “do no harm”? I am being a bit melodramatic, since the situation was not life-threatening. But it did involve my dad and has been on my mind, so I thought I would share the matter on my blog.
When the situation first started to unfold, I muttered under my breath, “What an asshole!” But in the technical sense, at least at it applies to leadership and work situations, the doctor in question did not meet the asshole criteria. Yes, there are such criteria! They are presented in a great book by Robert Sutton: The No Asshole Rule: Building a Civilized Workplace and Surviving One That Isn’t (2007). According to those rules*, the true asshole degrades and demeans colleagues on a regular basis. I don’t know the guy involved that well, so I guess I better just label him an unethical jerk!
HERE’S SOME BACKGROUND:
My dad lives in a convalescent hospital—and is doing just great. Since a major surgery several months ago, he has been under hospice care. The hospice care givers come several times a week to augment the care given by the facility. The two staffs work well together and keep me informed of any changes with my dad. My dad’s primary care doctor is part of the equation, visiting Dad once a month and being the first contact with the hospice staff if any needs or problems surface. There is another group associated with this well-working team: a medical group of doctors who are on call, as needed, if things go wrong and Dad needs immediate care and intervention from someone other than his main doctor. They were part of the team that made the original recommendation that Dad be placed on hospice, but since then, their services have not really been needed. Dad’s day-to-day care is seen to by the facility and hospice staff and his primary care doctor.
NOW, THE NEW SITUATION:
The other day I received a call from Dr. Jerk. [Not his real name.] He reminded me we had talked before when getting my dad placed in hospice. During his call, he announced that Dad needed to be moved under the care of a different hospice group. I asked why, and he simply said that it was being recommended by Dad’s doctors. I asked whether Dad’s primary care doctor would stay with him even if this move took place. Dr. Jerk said, “Yes, he would as part of the team.” That tipped me off a bit that something was not quite right; Dad’s primary care doctor is a woman. I asked further questions, and the guy reluctantly said that, “Well, you could stay with the original hospice, but the doctors would no longer be involved since they were no longer under contract with that hospice.” I said I needed to talk to my sister (we share power of attorney) as well as my dad’s primary care doctor and the original hospice, but I would get back to him with a decision.
Okay. So the truth seems to be that in order for Dr. Jerk and his colleagues to keep being paid for their consulting relationship with my dad via his hospice, my dad needed to be under the care of a hospice that they had a relationship with. So their version of the truth was that Dad needed to change hospices—which is not quite accurate. If I had not asked questions, and just signed the papers as I was being encouraged to do, they would continue to be paid. If things ended there, this matter would not be running around in my head as much as it is.
When I made some phone calls to clarify things, other deceptions became evident:
- My dad’s primary doctor knew nothing about the change and would stay with my dad no matter what hospice he was associated with. She is not directly associated with Dr. Jerk and his team, but she works with them since she is my dad’s doctor—as she would work with any hospice and their extended staff.
- The original hospice would not give details, but they had opted not to renew the contract with the doctor’s group in question.
- Apparently, Dr. Jerk is not a medical doctor. He has a doctorate of some sort, so he can call himself “doctor.” But then I can too, and I know nothing about medicine. Given the medical context within which this guy works, most will assume his “doctor title” equates with M.D. His actual credentials are not bad; he is a nurse practitioner. I trust and value nurse practitioners. But why not be up front about his training and title?
- The original hospice said they had heard from a few other patients with questions about this suggested change being raised by Dr. Jerk and his group. Many of the elderly are signing over care without asking questions because their doctors told them to. The patients do not really realize that the change would remove equipment ordered by the original hospice until the new place ordered it again. And that the weekly caregivers they had built a relationship with would change as well.
- When I talked to the social worker at my dad’s facility, she acknowledged that the hospital worked with both hospices. She said good things about the original one my dad is with, but was silent on the other one. By the end of our conversation, it was clear she thought the decision to keep my dad with the original hospice was a good one.
- Dr. Jerk had Dad sign a transfer order! He did that either before he talked to me and said nothing about it, or after I said no decision yet and had not gotten back to him. Either scenario is unacceptable! BTW: I got back to his office with my firm decision not to change Dad’s hospice in less than 24 hours, so his actions were not because it had been days of no action on my part. Also, he included my dad’s primary care doctor on the form as part of the doctors requesting the transfer; she knew nothing about it. My dad, of course, does not remember signing anything.
- More paperwork had to be processed to keep Dad with his original hospice because Dr. Jerk had already submitted the transfer order with dad’s inappropriate signature; again, my sister and I have power of attorney, a fact Dr. Jerk knew because we talked about it. Given that paper was on file, the original hospice had to file papers to keep things as they were.
- Dr. Jerk also told the new hospice to call me to set up an appointment to sign papers. They did the next morning before I had a chance to call Dr. Jerk back with my decision. I love how so many people were having to waste time regarding this matter.
I know this is not a huge incident. And everything is fine for my dad, so all is well. I also know that part of the reason this matter has been running around my head is because a more serious problem I am addressing also involves lies and half-truths and unethical manipulations. It will be great when that problem is finally resolved, hopefully within a few months. But with this matter, it seems clear to me that Dr. Jerk was trying to use his patients’ general trust of doctors to get changes made, so his medical group would still get paid. I also know Dad’s original hospice would want to keep patients, so they too would continue to be paid. Everyone’s motives include something that benefits them. It is how the matter was addressed that bothers me. This whole thing confirms for me a distinction made by Terry Pearce in Leading Out Loud (2003):
Your ability to manage is measured by what you know and what you get done, but your ability to lead is measured not only by your competence but also by your ability to communicate who you are and what you stand for.
THE LESSON LEARNED:
I firmly stand by my conviction that honesty and integrity coupled with a strong commitment to moral and ethical behavior are needed to keep everyday life sane, humane. The professional arena demands those qualities even more than everyday life. If I cannot trust that someone will not manipulate the truth to suit his needs and continue being paid, how could I trust any medical intervention he might provide at a later date? It seems that my mom was right after all: Honesty is the best policy. Therefore, I need to continue to strive to be honest and ethical in all my dealings and to willingly associate only with those who do so as well. Also, it is important to remember to always ask questions, especially of those in positions of authority. And to watch what you say and how you say it—those words do give a glimpse into your values and intentions.
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“Live in such a way that you would not be ashamed to sell your parrot to the town gossip.” Will Rogers
“When morality comes up against profit, it is seldom that profit loses.” Shirley Chisholm
“The function of education, therefore, is to teach one to think intensively and to think critically. But education which stops with efficiency may prove the greatest menace to society. The most dangerous criminal may be the man gifted with reason, but with no morals.” Martin Luther King Jr.
“Right is right, and wrong is wrong, and a body ain’t got no business doing wrong when he ain’t ignorant and knows better.” Mark Twain
“Would you want to do business with a person who was 99% honest?” Sidney Madwed
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*If you are working with a real asshole, you might be able to address the problem. Robert Sutton wrote a great little book—The No Asshole Rule—that delineates the actions assholes routinely take. The majority of his book, however, gives tips and tools on how to implement and enforce the basics needed to weed out the assholes. To help you assess if you are working and/or living with assholes, here is what Sutton calls “The Dirty Dozen.”
The Dirty Dozen
Common Everyday Actions that Assholes Use
- Invading one’s “personal territory”
- Uninvited physical contact
- Threats and intimidation, both verbal and nonverbal
- “Sarcastic jokes” and “teasing” used as insult delivery systems
- Withering e-mail flames
- Status slaps intended to humiliate their victims
- Pubic shaming or “status degradation” rituals
- Rude interruptions
- Two-faced attacks
- Dirty looks
- Treating people as if they were invisible