Manes and Associates

Reality TV isn’t. In your daily reality, have you ever had the chance to choose a mate from dozens of beautiful people and win a million dollars in the process? Have you ever lived on a remote island for weeks for any reason? Did you ever feel the need to eat worms, sky dive, or sit in a box filled with roaches? In today’s world this is good TV, but it’s not reality.

Management 101 isn’t. Management 101 is one of the first courses you take in business school. The concepts presented and the processes proposed make so much sense and appear so easy, you say, “I can do this.” Then you graduate and attempt to apply these concepts in your office, store, plant, or warehouse. More often than not, the results you achieve do not parallel what you learned. Business courses offer great theory but are often far removed from reality.

Remember MBWA – Management by Wandering Around. Maybe it’s time for business owners to learn RBWA – Reality by Wandering Around. Maybe it’s time to forget the perfect world of academia, and observe what’s really happening; apply a dose of common sense; recognize that the world, and your organization, doesn’t work from a script, and get the best results you can from the resources you have. Now that’s reality, and that’s management.

Let’s wander through some real life episodes that I observed during a most memorable hospital experience. The episodes conclude with a common sense observation.

Observation 1 – Common sense isn’t

Common sense is a textbook oxymoron. The sign says, “Wet Paint,” and yet we touch it then get upset when our finger gets sticky. The sign on my mother-in-law’s door said “No BP / Venipuncture to left arm”. The nurse or aide walked into the room and began to inject something into my mother-in-law’s left arm. When asked about the procedure and its apparent conflict with the sign, the nurse said, “I didn’t read it.”

Develop and use your common sense. Read the signs, particularly in situations where the people who work with you or who work on you don’t.

Observation 2 – Maslow had it right

Maslow believed that unmet needs motivate. His hierarchy cited survival, security, social, self-esteem, and self-actualization as the ranking of our needs.

Shortly after my mother-in-law arrived at the hospital from a very long ambulance ride, the pain medication she had been given wore off. She started to hurt. When she asked for pain medicine, the hospital staff (who had been alerted hours earlier of her pending arrival) announced that the doctor had not ordered it yet.

I thought that the system might have anticipated that an eighty something year-old traveling in the back end of an ambulance for over 12 hours might need something for pain when she arrived. Picture your grandma screaming in pain as you read this.

When I encouraged the staff to call the doctor, they did. But that call only created the authority to give a pill, it did not produce the medication. Unfortunately, the computer can’t deliver the pill to the patient. Only humans do that. Humans take breaks and change shifts, computers don’t. Since my mother-in-law was so inconsiderate as to need medicine during a shift change, she would have to hurt and wait.

Finally, after my considerable encouragement, this system that has great scores for patient satisfaction delivered to her a pain pill. Returning to Maslow’s theory, I believe severe pain is on the survival level of the Maslow pyramid.

The next conflict to occur between delivery of care and patient satisfaction began at her arrival at 4:30 a.m. and concluded at 3:00 p.m. This was when we discovered that they forgot to feed the patient. Suffice it to say, when you’re hurting and hungry and about to be injected in your left arm, versus the correct one, it’s hard to be too concerned about HIPAA, policies and procedures, or quality satisfaction ratings.

Survival and security are primary needs. Once these needs are met, we become more interested in social, self-esteem and self-actualization issues.

Treat the people issues first. The paperwork can follow.

Observation 3 – Touched by an angel or the weakest link

Not all service during my mother-in-law’s hospital stay was bad. Most actually was good. Most professionals were. Some were even angels. A physician assistant made rehab a treat. One of the nuns in the administrative office mastered the art of putting the customer first and touching hearts.

Unfortunately, in a competitive marketplace, where excellence is the baseline, customers soon forget or take for granted the exceptional performers and remember only the bad players and bad experiences, your weakest link.

A heavenly experience can be turned to hell by a single bad event, player or result.

Observation 4 – The mike is always live

Remember President Reagan’s off-the-record but on-the-air comments about bombing the “commies”? Or, more recently, President Joe Biden’s derogatory remark about Fox News Reporter Peter Doocy? These may have been cute remarks among friends, but incredibly dumb as broadcasts.

When we buzzed the hospital floor’s front desk, it took them 15 minutes to respond. A safe assumption may have been that hospital staff was handling other emergencies. As a practical matter, the intercom is a two-way means of communication. It was live, and we could hear the real reason for the delay. The staff was busy not at work but at play.

In a digital world, eyes and ears are everywhere. Be careful what you do and say.

Observation 5 – Customer service by great communicators

Hospitals and other businesses (in hospitals the customers may be naked and in pain, which makes them a little more dependent than in other businesses) spend billions of dollars teaching/studying customer service, communication skills and outcomes.

Unfortunately, many of these dollars and efforts are wasted because the focus is on the process and not the people. Great communicators don’t talk; they listen and observe. As a customer, I don’t want to know how smart you are; I want you to recognize how smart I am. It’s not about your ego; it’s about the customer’s.

Too often in this laboratory of healthcare and people, I observe very smart and highly trained professionals missing the communications boat by talking down to patients in language they don’t understand and at a pace they can’t retain.

As I observed, the best communications occurred with the housekeeping staff and the bedpan operator. Maybe because these professionals had more time, less ego, and by the nature of their jobs made a more intimate connection with the patient. They were doing something for the patient, not doing something to the patient.

Maybe communications/customer service classes should be taught/facilitated by the bedpan operators, not other professionals.

Appropriate communication is key to customer service.

Observation 6 – Dream, dream and dream

Dreams can be visions or nightmares. What I’ll remember about the hospital experience will be the nightmare part. The power of dreams as a vision was reinforced when I left the hospital to go to the opening of the new office of the LHC Group. The need for a new facility was created by tremendous growth and success. From 1994, as a one-nurse home care agency in Palmetto, Louisiana, this organization grew to 32,000 employees in 35 states. The foundation for success, as explained by its president Keith Myers, was a vision and mantra – “It’s all about helping people.”

Cutting the ribbon was a Cajun girl, schoolteacher, mom and grandma from 15 miles down the road. Her name – Kathleen Babineaux Blanco, governor of Louisiana. A good, honest, and hard working person, Gov. Blanco did not fit the stereotype of a charismatic leader like JFK or Ronald Reagan. I see her success as the result of a dream vision, discipline and hard work.

Einstein said, “Imagination is more important than knowledge.” First, dream.

Observation 7 – A workbench or a canvas

Most of the people most of the time, enjoy their jobs. They like building, cooking, teaching, making, recording, whatever it is they do. The only problem is the interruptions and unreasonable demands by those “darn customers.” In the hospital, I observed very well educated, skilled and trained professionals performing procedures on patients’ body parts that have a condition.

Here’s the thing – patients/customers are not workbenches where you go to practice a skill. They are living, breathing beings with needs and expectations. The conditions – cancer, fractures, congestive heart failure, and others – and the body parts – hips, kidneys, brains, knees, feet, arms and hands – are not the patient. Recognize, treat and cure the whole patient. In so doing you will probably get to treat the conditions you were trained for and enjoy treating.

Hopefully, in the future, the patient will no longer be the bench where professionals go to work, but rather the canvas where skilled artists apply the strokes from their specialty brush to complete a finished picture of health and wellness.

Health and wellness are more than the absence of sickness. It’s all about the people.

Observation 8 – Never debate a customer’s feelings

As a customer, I know when I’m upset. You don’t. How can you ever win a debate with me about my feelings? If I’m upset, allow me to vent. My perceptions may be wrong, but my feelings are true. After I vent, you may be able to show me a different way to see the facts, change my perception and win back the relationship.

For the best results, see your customer’s world through your customer’s eyes, not yours. Help your customer survive, and you will prosper.

It’s time to get real.

MICHAEL G. MANES is the owner of Manes and Associates, a New Iberia-based consulting business focusing on planning, sales and operations, and change. Manes can be reached at or 337-577-3885.