Scatter my ashes here...

Scatter my ashes here...
scatter my ashes in the desert...

Monday, June 10, 2019

Never Trust a Teflon Suit and Other Truths about Corporate Healthcare

Hi, my name is Alene and I’m in recovery from the U.S. corporate healthcare system, after another relapse.

The latest relapse was around my husband being forced out of his job where he's been working for twelve years. He did find another job, in a different line of work but still in healthcare, on his own terms, and our lives will be much improved for it, despite nearly a fifty percent cut in pay. But this see-through scheme is becoming all too common for people nearing retirement age.

With barely seven years to go until retirement, and 30 years of experience in the same line of work, and 18 with this particular company, he got the typical corporate healthcare tactics foisted upon him. This shit is so transparent it's a joke, I can't even believe they think these tricks will work anymore.

Side note: For those of you who aren't in healthcare, one new vocabulary word for you: HCAHPS. It means Hospital Consumer Assessment of Healthcare Providers and Systems) and it is THE HOLY GRAIL, the Pope's ring, the GOD of corporate healthcare executives. It is their raison d'etre. It is their data orgasm. It isn't everything, it's the ONLY thing. Also known as "patient satisfaction" scores. It's as if the currency used in the industry has been changed from dollars to HCAHPS. (All about the Benjamins, baby.)

You know, the one where they drop little hints about outsourcing if the HCAHPS (patient satisfaction) scores don't come up. Then the personal snide remarks, "You've changed". Then the one where they suddenly blindside you and kick you below the belt with all the things you're doing wrong, "Do you even know how to do your job?"

And they pretend like they are going to "help" you, via the "performance improvement plan". Which is a way to start gathering data to be used against you at the time it's convenient for them to fire you. But instead of following through, they leave you hanging- no specific timelines, measurable improvement points, or what exactly it is that you're doing wrong. When you try to pin them down, they squirm out of it with vague mumbles "four to six months".

Four to six months of what? Until they fire you? Or until they outsource the entire department? Or until they can find someone to take your place who isn't at the top of the pay scale?

They say they are going to "help" you, but when those meetings are supposed to occur, suddenly they become unimportant, forgotten, or pushed aside.

If you've been working in the same job and place for 12 years and no one has ever had a problem with your interviewing style and your hiring methods and your patient satisfaction scores and then all of a sudden they are- there is an ulterior motive. Especially when your past evaluations haven't reflected any of these things.

And then the barely 40-something snot-nosed, suck-up, little suited asshole who "worked" his way up the teflon corporate ladder-like an endoscope works its way up your colon- he can't even look at you in the eye, as he makes the decision to axe you.

And does it using the convenient excuse, the tool, of HCAPHS scores not high enough, that means smaller bonuses for the snot-nose and since he only makes more money in a year than you've made over the entire decade-plus duration of your time there, that would be really fucking traumatic for him. One less vacation home at a ski resort. The horror.

Infection control? Patient safety? People skills? Attention to detail in these things? No, not good enough for the snot-nose. You gotta have that arbitrary HCAHPS ranking. Why? Because HCAHPS data is GOD, so says the god of corporate healthcare.

Are the snot-noses really that important that they can throw away other people, on a whim, deciding someone has no value- basically saying they contribute no value to the organization and discard them like a piece of trash?

The feelings people experience when subjected to this sort of behavior- the dehumanization, the lack of kindness, appreciation, gratitude, empathy, or fairness, show that the corporation is a machine- as lightweight, yet profit-heavy, as possible.

Why can't executives be honest and straightforward, without eroding trust and someone’s self esteem. How about, “We appreciate that you’ve worked hard for us and sacrificed time with your family for ___ years. We have made some decisions that are going to result in us eliminating your position. Can we help you find another job?”

It's not THAT hard.

Secret Initiation Rites of Corporate Healthcare Executives (not including the handshake)

I am convinced that in the secret initiation rites of corporate healthcare executives, there is a test, and here's a sample question from that test:

Q. Just say, for example, it takes a certain amount of time for a chemical to do its job to thoroughly achieve its disinfection capacity, and the organization has chosen that chemical for the purpose of disinfection because there is evidence for its effectiveness, and is within the budget. The evidence came from research studies allowing the chemical to sit on a surface for a given amount of time. But that amount of time is longer than you are willing to allow staff to take to thoroughly clean a hospital room between patients, and since you, the snot-nosed executive, insist that they go faster and give them fewer staff to work with, then you have to choose between several options: (make sure you pick the right one!)

A. pay for more staff,
B. find a different, faster acting chemical if there is one within your budget,
C. shut the fuck up and let them do their job,
D. face the consequences of a higher infection rate, or
E. pressure the managers of all departments to make their nursing and support staff work harder and faster with fewer people and resources, expect the entire organization to turnover hospital beds faster than the amount of time it takes to thoroughly disinfect, and if anything goes wrong, blame junior management.

The correct answer is________. (fill in the blank)

There are some ugly truths in the corporate world and not only are they getting worse, they are being encouraged by a culture that ignores individual contributions in favor of monetary and tangible wealth-building units of currency. There’s a laser focus on whatever measure translates to more dollars and profit for the organization’s top tier. It is enforced by people hired as pitbulls, masters of deception, and compliant, robotic drones. No one is safe.

The worst thing about it, is that ultimately, it’s the healthcare “consumer”, the patient, who suffers, as well as all members of their community.

The people in a community who provide the labor for a healthcare organization, regardless of the level of skill or status in the healthcare system, are human beings first. They have lives, families, emotions, needs, and are connected to a community. As human beings, they also have basic rights, that seem to be getting encroached upon incrementally, as our democracy has declined into oligarchy and our wealth distribution has become more extremely unequal.

This has been a really hard post to write because my emotions have been so tangled up and so many feelings around past experiences of my own have been triggered by this.

I’ve worked in academia where there was a boys’ club. I’ve worked in the business world where there was sexual harassment. And I’ve worked in healthcare where there’s an insidious current favoring those who don’t question, simply comply, and sacrifice their entire lives until they are physically and/or mentally broken, then discarded.

I think they’re all reprehensible, but healthcare is completely out of control and it’s the industry that directly impacts whether people live or die.

None of this is a new discovery, these are things we’ve known and understood, and quite consciously, for a long time. We’ve been living in the United States our whole lives. It’s just that over time, things in the working world seem to have gotten a lot more ruthless and anti-human. There’s a complete lack of acknowledgement and appreciation of the value of individual human beings and what they bring to the workplace.

Two Things On My Mind

One is people’s basic needs, and another is human rights. I’m going to talk about Maslow’s hierarchy of needs and the Universal Declaration of Human Rights, not because these are perfect models or documents, but because most people are at least vaguely familiar with them, or have at least heard of them.

When I talk about human rights I am quite aware that no one is being coerced to work in these increasingly abusive situations, but there are very few alternatives if you want to work in nursing or the healthcare discipline in which you were educated and trained, and the mass exodus of nurses and ongoing nursing shortages are a direct consequence of this abusive behavior on the part of administrators. People do have a choice to leave, at great personal financial peril, but they can leave freely if they want to. But think about what people need in the U.S. to maintain a certain standard of living.

If you think about a visual model of Maslow’s Hierarchy of needs- there are three levels, all of which start from the bottom and build into a pyramid. Basic needs include the physiological safety and shelter needs, Psychological needs include belongingness & love and esteem, and at the top are self-fulfillment needs, also called self-actualization.

Look at the universal declaration of human rights and you will see throughout the document that there are multiple instances of violations here in the United States with regard to everyday life and especially in these healthcare workplaces. Look carefully at Articles 24, 25, 26, 29, 30. Then think about how corporations treat their employees. I think in the U.S. workplace we are coming dangerously close to practices, that in a setting without choice to freely leave, even in the face of financial ruin, would be called human rights violations.

Some of the language in the human rights declaration includes phrases such as:

  • act toward one another in a spirit of brotherhood,
  • no person shall be subject to...degrading treatment,
  • freedom of political or other opinion,
  • all are equal before the law and entitled without discrimination to equal protection of the law
  • Everyone has the right to freedom of peaceful assembly and association
  • Everyone has the right to economic, social and cultural rights indispensable for his dignity and the free development of his personality.
  • Everyone has the right to rest and leisure, including reasonable limitation of working hours and periodic holidays with pay.

It seems that in this country, we’re toeing the line on human rights violations in many ways. Making a profit is not a basic human right, and really, if it means you have taken away from someone else’s ability to fulfill their basic human needs, that's not good. Not cool. No bueno.

I propose ending the declaration of human rights with something to the effect of: The right to profit should not supercede anyone’s basic needs, abuse their psychological well-being, or violate their human rights as stated above.

And we need to have a new code of ethics around business operations in this country. Because most corporations are ethically challenged to the point of being out of control.

Think about this, for example: in a healthcare organization, employees pay the same for their benefits whether they earn $12 an hour or $500 an hour, as CEOs do. That is not right, either. Since we don’t have universal healthcare and employers provide private insurance for many working people, they should also consider that there is a gap in affordability and apply a proportional deduction from paychecks. Then healthcare would be a real benefit, helping the lower paid employees avoid a poor tax on their health insurance.

A Few Solutions

So let’s look specifically at a few of the places we could make improvements. This is just a tiny list- my wish list is massive. Corporations and big business should:

1. Be good citizens-take responsibility for the communities they impact. Pay full taxes, nonprofit status is not allowed to be exploited. No more disguising profits as expenditures.  Stop outsourcing, cutting jobs without taking care of people they displace or push out, no matter how much they have given to the organization. Be mindful that these people have families who have also been impacted by the employees' sacrifices and will be impacted by the displaced workers' status.

2. Eliminate golden parachutes and "special" status for executives. If you leave for another job, you get your last paycheck from the old job, and then collect your first paycheck from the next job. No more padding in between. All benefits should be equally distributed and should not disproportionately cost lower paid workers more. No VIP treatment if the CEO or family members get sick. They get treated the same as any other patient. No picking their nurses, no special accommodations, no altered staffing ratios for that purpose.

3. Be transparent about the organization's plans and practices. No secret meetings or huddles, have representation of all levels of workers in decision making and on boards. No surprises for the masses.

4. Be banned from using money to influence the political arena- no more lobbying to protect self-interest and industry interest.  Stop union busting tactics, stop using deterrents to organized labor.

Some takeaways:

1. Old ideas of retirement and planning for it are no longer applicable. You need to assume you won’t live up to your full earning potential in the last 10-15 years before retirement, and most likely will be making less money at that time.

2. Don’t put up with abuse from your superiors at work. Fuck them. They have plenty of excuses and they’ll use every last one. Be brave, get out. If you live a "middle class" lifestyle, you can figure out a way to get by on less.

3. Their game is to pull in as much money as possible, cut costs and minimize risk to the organization, no matter what, even if it’s detrimental to patient and worker safety.

4. Healthcare is neither. In this profit-obsessed industry we have lost our humanity, and our ability to care. And that’s not healthy.

5. Your job is a job. It is a tool to bring you financial assistance in addition to contributing to society and furthering your own self- actualization/esteem. It is not something that should hurt your health or where you should sacrifice beyond a reasonable workday. And you should be compensated fairly for it. You should do the work of one person, staying reasonably busy for 8 or so hours a day. Not 12 hours. Not 7 days a week. Not for a period of time that does not allow you to do the basic things to take care of yourself and your health- eating, sleeping, seeing your family and caring for your own and their needs, rest time including mental rest. You should not feel threatened that you will lose the roof over your head or not be able to feed yourself. You shouldn’t be coerced into working more hours or taking on two or three people’s jobs.

6. I am unapologetic to those who somehow think the corrupt and distorted market can fix itself without regulation. Or to those who think that if you’re poor it’s your own fault and all the other lame excuses about pulling yourself up by your bootstraps.  I look at the rest of the world and the countries where they care for their people and don’t let them slip through the cracks, have socioeconomic safety nets, and provide universal healthcare. They have a better standard of living overall because they don’t have the wealth disparity that we do and people are cared for from birth until death and there isn’t the degree of extreme poverty as we have here.

7. No corporation should have the power to impact communities and individuals’ lives in this way. We need to get money out of politics. And we need a rebirth, reinforcement, and then actual enforcement, of antitrust laws.

8. We need to stop our addiction to wealth, fame, money, and power. We need to reform what’s become a national culture of shallow, lazy, self-absorbed, materially-obsessed, apathetic people. If something doesn't affect you directly, that's not a pass. You need to see yourself as a citizen of the community, your country, and the planet. What affects one person affects us all. When one person suffers injustice it impacts everyone. That bubble you want to keep living in, pretending like it's someone else's problem, is really the walls of your rectum. Get your head out of your ass. And once you pull it out, get off it and do something for the good of humankind.

9. Then, and only then, will our lives will be so much better and so much less stressful. And this country and world will be worth living in.