THE POLICY THINKSHOP "Think Together"

Public Policy is social agreement written down as a universal guide for social action. We at The Policy ThinkShop share information so others can think and act in the best possible understanding of "The Public Interest."

Five million families and children will now sleep a little easier. How will the new Latino/Hispanic immigrant status impact healthcare policy?

Being “in the shadows” has long been a healthcare access issue.  The broken healthcare system has been aggravated by a broken immigration system. Immigration and healthcare are tied together in many ways, especially for the economically disadvantaged.

According to the New York Times:

What Is President Obama’s Immigration Plan?

President Obama announced on Thursday evening a series of executive actions to grant up to five million unauthorized immigrants protection from deportation. The president is also planning actions to direct law enforcement priorities toward criminals, allow high-skilled workers to move or change jobs more easily, and streamline visa and court procedures, among others. NOV. 20, 2014 RELATED ARTICLE

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Who could be affected?

The president’s plan is expected to affect up to five million of the nation’s unauthorized immigrant population, currently 11.4 million according to the Migration Policy Institute. It would create a new program of deferrals for approximately 3.7 undocumented parents of American citizens or legal permanent residents who have been in the country for at least five years. Deferrals would include authorization to work and would be granted for three years at a time.

It would also expand a program created by the administration in 2012 called Deferred Action for Childhood Arrivals, or DACA, which allows young people who were brought into the country as children to apply for deportation deferrals and work permits. The plan would extend eligibility to people who entered the United States as children before January 2010 (the cutoff is currently June 15, 2007). It would also increase the deferral period to three years from two years and eliminate the requirement that applicants be under 31 years old. About 1.2 million young immigrants are currently eligible, and the new plan would expand eligibility to approximately 300,000 more.

It would not provide a path to full legal status or benefits under the Affordable Care Act. Officials have said that the president’s plan will not provide specific protection for farm workers or parents of DACA-eligible immigrants.

Filed under: ACA and Medicaid, Blogosphere, Data Trends - American Demographics and Public Opinion, Family Policy, Feminization of Poverty, Health Literacy, Health Policy, Healthcare Reform, Immigration, Latinos, Maternal and Child Health, Medicaid, News, Public Health, Public Policy,

Ignore Emotional Intelligence at Your Own Risk: Policy ThinkShop comments on Harvard Business Review article by Claudio Fernández-Aráoz

Emotional intelligence (also known as “EQ”) is an idea that grew up in academia, was popularized on pop psychology shelves and, more recently, has been made useful in leadership development and organizational management circles. From its conception, it was juxtaposed to the idea of Intelligence Quotient (IQ). Its lofty intellectual beginnings notwithstanding, EQ has been embraced by so many for so many reasons that its early paradigmatic intentions may now be lost to the many.

Popular ideas live in the minds of the many and, perhaps because of their simplicity and utility, become sustainable and prolific for both producers and consumers. Academic ideas and constructs more often tend to be quite different from popular ideas. They differ in that their currency tends to require intellectual specialization, academic environments akin to monasteries, and individuals with a broad understanding of the numerous currents and variables that give academic products their place in the refereed conversation of the nation’s professorial ranks. Emotional intelligence is an important flashpoint for forces with differing origins yet ideally common destinations–thinking individuals wanting to promote social good and noble ends. Daniel Goleman and Adam Grant are two such forces; they are social communicative pundits in the ongoing tug of war that will define the proper and productive utility, and place, of emotional intelligence, as a leadership and workforce development concept.

We may be exceedingly amazed to see academics, intellectuals, pundits, and intellectual entrepreneurs spar in the marketplace of ideas in order to promote their worth and place in the market. Certainly, Adam Grant steps into the breach and tries to hold Goleman to task for what he sees as academic obfuscation. Interestingly, he borders on ad hominem intentions and plain teasing. Perhaps Adam Grant is pandering to this electronic social media medium and finds such rhetorical tools necessary. Perhaps the conversation that is sought here with leaders understands that today’s leaders are not Plato’s philosopher kings. Indeed, Grant does not seem to see the business of management outside of specific emotional terrain so touchy feely as Goleman would. It is plain to see that Daniel Goleman’s place is secure, as the high priest of pop psychology, because his Ph.D. in Psychology and his perch on the NYTs allowed him to popularly run with the “EQ” concept and build an entrepreneurial empire which may outlive him and the rest of us. To be sure, the spoils from popular media endeavors have favored Goleman’s lot, EQ’s intellectual forefathers have not similarly gained (John Mayer and Peter Salovey). This does not bode well for future intellectuals lacking entrepreneurial prowess. You will find Mr. Grant on LinkedIn though, promoting his intellectual wares; he’ll do just fine.

Interestingly, we can look at Salovey’s dissertation from way back in 1986 for the early intellectual ground from which the concept of EQ grew (P. Salovey, The Effects of Mood and Focus of Attention on Self-Relevant Thoughts and Helping Intention, unpublished doctoral dissertation, Yale University, 1986). We can also look at the role of popular psychology in our culture to find similar ground for Goleman’s efforts and success. Mayer and Salovey are the original promoters of the ideas and of the intellectual history which gave intellectual buoyancy to the concept. Daniel Goleman refers to his encounter with the work of these two men in a passing way and diminishes their importance by alluding to the lack of stature of the journal in which they published the original 1990 article “Emotional Intelligence.” Goleman has turned the work of these men into a cottage industry and his published retort to Grant shows his ability to popularly promote the term “EQ” in contrast to feebly defending it. Perhaps Goleman is safe behind the popularity curtain always protecting his wizard like reputation. Up and coming scholar, Adam Grant, rightly exposes Goleman’s use of the concept as less relevant outside the parameters of academic rigor and of the realms of possible scientific discipline and emotive applications.

The concept has grown to mean so many things to so many people that it now means specifically very little within the confines of academic, intellectual or theoretical query. Salovey and Mayer’s contributions to modern management and leadership are now popularly distant from their original rigorous work. The popular development of that work may possibly have obstructed the original potential of Salovey and Mayer’s ideas and constructs, further obfuscating the road to needed progressive managerial and leadership applications. Goleman has made it common coin and personal gain–neither being efforts which have contributed significantly in taking the concept further along its original intellectual journey; nor has it helped in the building of necessary theoretical constructs that can give us an applied framework that allows for clarity regarding how and when it is useful as a heuristic model for organizational, group, or individual purposes. To be sure, Goleman now makes these claims; but his arguments are devoid of the rigor evident in the original works of the real pioneers from which the potentially useful constructs originate.

Centuries have passed since the monastic catacombs of the original academy, with its religious literati and the ensuing work of the eventually enlightened philosophers and scientists. Work that was preserved and discriminatingly shared through coveted books and into modernity. But all that has now changed and continues to change. Ideas are now increasingly, and literally, in the clouds, ubiquitous cannon fodder for daily consumption; their value and retention seems now to be more tethered to the common cause than to the lofty undertaking. Can you imagine that?

via Ignore Emotional Intelligence at Your Own Risk.

Filed under: Blogosphere, Culture Think, Emotional Intelligence, Leadership, Policy ThinkShop Comments on other media platforms

Moving resources is most often easier than moving minds: Minding our mindfulness in health behavior change.

Healthcare funders, and often healthcare leaders themselves, fail to measure and value the role of emotions in the social interactive processes they must manage to be successful in their work.   Both as responsible stewards of the public trust and as managers of people helping people, healthcare executives, philanthropists and frontline managers must master and value the role that emotions play in all forms of people helping.

Human behavior is central to every human activity.  Nowhere is this more important than in the interpersonal processes required in providing healthcare services.  Successful or efficacious human behavior (whatever one defines or measures success to be) is often dependent on mood, emotions, and psychological process that often go unnoticed.  Although emotions are hard to define, measure and see, our social interactions are often undermined by the miscommunications and misunderstandings that abound when we fail to master them.  Our lack of attention to emotional currents often capsizes our projects and goals.  Enter emotional intelligence, and our need as a society to mind our mindfulness.

Behavioral health is compromised by diseases that are addressed by our mental health and addiction services organizations.  The competencies required for administering behavioral health systems may be quite different from those required to provide and receive effective services.  Recruiting, developing and retaining behavioral health services talent is rarely central to a behavioral health plan, or even provider organizations.   Instead, like most health organizations, behavioral health organizations are most often bureaucracies that manage mortar and brick resources that sustain funding relationships, payment/reimbursement systems, and advocate for a handful of vocal community stakeholders.  The development of practice, both theory, modalities, and efficacies (workforce development) is often relegated to a subunit whose funding and leadership resources may be once removed from the daily operational priorities of the organization.  keeping the doors open may, first and foremost, require material, financial and political resources well outside of workforce considerations.  Perhaps this is the case because measuring practice efficacy and workforce competencies, though vital for direct service quality and outcomes, is not so easily measured or assessed.  Instead, funding and helping organizations (philanthropic investors, government funders, and private do gooders) rely on reports.  Outcomes (real community or service recipient impact/change, progress) and practice efficacy are rarely measured; and when they are, it is episodic, one time, or relegated to academic collaborations that are rarely formal and ongoing, much less sustainable and included in operational plans, accreditation activities, or funding considerations.  It’s no wonder, then, why most health and human service efforts fail in terms of how and who provides the services and people’s ability to take advantage of those services.

Because behavioral health challenges are principally personal and depend on the functioning of the mind, they require insightful and mindful approaches on both the part of the service recipient and the service provider.

We all at one time or another let our emotions carry us to places we thought we could never reach; and to some places and situations we never intended to be in. Emotions are an important part of our successes and failures; and that includes the emotions that drive the actions of others who impact our journey. It is hard to imagine that learning to manage our emotions and to better understand the emotions of others is not always seen as an extremely desirable thing that we can pursue in a straightforward manner. But for many it is not. The concepts that cover this important topic, “emotional literacy” and “emotional competence,” can be summarized in the operational definition of emotional intelligence as follows:

Definition of Emotional Intelligence (EQ): “… the subset of social intelligence that involves the ability to monitor one’s own and other’s feelings and emotions, to discriminate among them and to use this information to guide one’s thinking and actions. We posit that life tasks such as those described by Cantor and her colleagues and constructive thinking defined by Epstein are laden with affective information, that this affective information must be processed (perhaps differently than the cognitive information), and that individuals may differ in the skill with which they do so. Emotional intelligence is also a part of Gardner’s view of social intelligence, which he refers to as the personal intelligences. Like social intelligence, the personal intelligences (divided into inter- and intra­ personal intelligence) include knowledge about the self and about others. One aspect of the personal intelligence relates to feelings and is quite close to what we call “emotional intelligence.” John Mayer and Peter Salovey, 1990

We certainly need creativity on our side when addressing the need for innovative ideas in the area of resource investment in improving and sustaining the health of communities. Emotional Intelligence may be a more useful conception of those aspect of human intelligence needed when understanding, promoting, and/or addressing many of today’s most vexing social interaction problems. For example, finding ways for organizations to embrace, recruit, and implement human diversity; this is especially true in organizations that, of necessity, must deal with diverse communities. Philanthropic entities, government agencies, and healthcare businesses, that address social investing, healthcare planning, program development and implementation, are a good starting point.

Emotional Intelligence (also known as EQ) can be an important construct for defining, understanding, measuring, quantifying, and operationalizing the  professional competencies needed to build and implement more effective healthcare organizations.  Behavioral health is also a logical and much needed starting place.

Filed under: News, , , , , , , ,

America needs help building a more perfect union, again? “Scarcity changes how we think”

The current Republican victory either threatens healthcare access success or saves the day.  Perhaps it depends on what ideas you have to form an opinion on the matter.  Thousands of people inherit political and controversial opinions from their parents or grandparents.  But this is not our grandparent’s America.   Leadership today, and ideas to formulate solutions to our society’s most vexing social and economic challenges, must be as innovative as the ideas our forefathers forged to build our constitution.  They broke new ground to form a more perfect union.

America needs help in being more perfect today.  We need new ideas to help us support new social investments to address our collective responsibility to make sure that our form of government, and the leaders we put in charge, keep a fair balance regarding the social contract that makes us the greatest nation on earth.  Perhaps reading the current book “Scarcity: Why Having Too Little Means So Much,” by Mullainathan and Sharif, could help?

Jus about a year ago an important book was published regarding scarcity.  We were all probably a bit busy, so it did not cross our minds.  Interestingly, the book is about the very social and psychological reality that caused many of us to miss the opportunity.   We just don’t seem to have enough time in the day to do the things we need to do to make our life more manageable, more simple and, perhaps, more enjoyable.  Without mentioning the dated and overused thought model, “Maslow’s hierarchy of needs,” we are reminded of a person’s lack of efficacy when overwhelmed by environmental stimuli that dictate how we feel and perhaps what we do.  Such is the case in this important book on the effects on our minds and how our mind works when confronted by daily challenges.  The mind, the book’s thesis goes, has limits (“bandwidth”), and its focus is bound by our fixation on what matters among the many things coming at us.  The book is important for public health, healthcare services and health education, for example, because it gives us a less pejorative and judgmental way to look at people misbehaving.  Especially behaving in ways that seem irrational, or worse, lazy or undeserving, to us. Perhaps as health professionals, funders, planner and policy makers, we are distanced from the daily lives and realities of those confronted with our well intentioned helping systems and recommendations.   It can be daunting and frustrating.   This book may give us  hope.

Mullainathan and Sharif elaborate on a conception of the haves and the have nots that is nuanced, insightful and perhaps more pragmatic than any construct we have heretofore seen; Yes, in the war on poverty.  To be sure, decades have passed since our last great poverty reform (PRWORA, 1996 or Bill Clinton’s Welfare Reform Law).  We now have the ACA reform (Barak Obama’s Law).  This second salvo on our nation’s efforts to address the needs of the “have nots” is once again putting the poor under the looking glass.  Back in the 90s version we were looking at people, being helped, being too lazy and needing to be made to work while getting help in order to get off of the government dole.  Millions of people were thrown off of the welfare rolls and when it was all said and done a Government Accounting Office (GAO) report declared that the majority of people remaining on the rolls were ill and not employable.  This was an important report, by “objective” pundits representing the federal government; and you would think that would have been enough to usher in healthcare reform to address the urgent plight of this government policy defined and “vetted” group.  It wasn’t.

Perhaps due to our national political discourse and the focus on levels of unemployment that could not longer be explained by the “lazy people on welfare” phenomenon, the nation began to focus on working people, many who were not faring much better than people on welfare.  The struggling middle class and the “deserving working poor” became the popular political constituency.  The increasingly divided electorate called for new issue that could wedge open the door to a new group that could tip the electoral balance.  This need fueled to drive for an electoral strategy focus on new votes and created the conditions and demand for strategies promising to move this demographic to the polls.  Enter today’s healthcare reform scenario.

Perhaps this is why healthcare reform remains a political fight with uncertainties and future possibilities for failure.  Just as the end of the PRWORA’s success, in throwing the poor of the welfare rolls, may now echo the present reality where we will have disrupted thousands of families’ lives, only to throw them off the insurance rolls.

“Scarcity captures us because it is important, worthy of our attention, but we cannot fully choose when our minds will be riveted. We focus on scarcity even when we do not want to. We think about that impending project not only when we sit down to work on it but also when we are at home trying to help our child with her homework. The same automatic capture that helps us focus becomes a burden in the rest of life. Because we are preoccupied by scarcity, because our minds constantly return to it, we have less mind to give to the rest of life.”

via Scarcity changes how we think – Salon.com.

Filed under: Behavioral Health Outcomes, Blogosphere, Children and Poverty, Congressional Activity, consumers, Health Policy, Healthcare Reform, Policy ThinkShop Comments on other media platforms

Taking Care of Our Healthcare System: The Physician-Patient Encounter

Health Wordle 2014 LinkedIn

Medicine is an art and it is a consequential relationship

Healthcare is largely communication, behavior and understanding.  Physicians do most of their learning working with patients and learn to share that learning to help future patients.  Healthcare learning and help happens within the patient – physician helping relationship.  People helping people is always a wonderful thing to see, but it is also difficult and fraught with some of life’s most vexing and ironic contradictions. Human life and dignity are some of life’s most precious things; yet their value, in monetary terms, is often questioned. The value of a person’s health is often underrated–even by the person themselves. For this reason, it is often difficult to understand and manage healthcare policy priorities for society in general, in terms of public spending and health policy, and for healthcare leaders, in terms of prioritizing and evaluating the components that go into building and managing the primary care process.

The relationship between healthcare services available, healthcare needs, and healthcare outcomes is not always obvious. Nowhere is this more evident than in the conversation between a physician and the person who comes to them for help. To be sure, the physician – patient encounter must remain the locus of control to ensure healthcare quality in a way that balances patient interests, outcomes and healthcare system sustainability and affordability goals. Measuring healthcare quality and patient satisfaction continues to elude most healthcare leaders and systems. Society, however, demands it. Medicine is an art and its goals, preserving and promoting a healthy life, can usually be seen as humane and priceless. Sustaining that art in the professional and public spheres is another proposition. The many variables that have to come together to make the art of medicine function in an optimal way must always be measured by the experience of the provider and the service recipient. At least in the actual healthcare encounter moment, there is a unique opportunity to define and support the quality of the craft and its product.

Creating an environment that can sustain the art of medicine is one of the few universal needs of people in any society. Of course, this easily seen and agreed to truth is always mediated by business concerns and economic considerations. How can we preserve the art of medicine and at the same time design and sustain systems that can take care of all comers as well as balancing the budget of institutions (including governments and corporations) responsible for minding the business of caring?

Medicine is about people and physicians are people too

Most people don’t want to be sick, and to be truthful, they also don’t want to pay for being sick at the expense of what they see as competing personal and family budget essentials. Much of the literature on healthcare problems and on ways of “fixing the healthcare mess” revolves around paying the healthcare bill as the initial catalyst for caring about health. It is the main reason we come to the table as individuals concerned about our family, as leaders addressing budgets or as providers concerned about our role in practicing the healthcare caring profession with real people in real places. If we are going to look at changing how people feel and think about healthcare, we better look at supporting the role of physicians as professionals meeting the expectations of patients within the institutions where they practice; and we better look at the role of publics who pay the bills to sustain those institutions.

Community healthcare outcomes are the consequence of thousands of healthcare decisions at many levels. Chronic health conditions are the largest portion of illness and disease, as the drivers of costs and as ideal mediation points for behavioral health interventions. Chronic health conditions are most often a consequence of specific lifestyle related health activities or the lack there certain activities. In the first and final instance these health problems, and their resulting costs, are caused by health behaviors and can best be moderated by changes in those behaviors. The nexus for that hopeful work is the physician – patient therapeutic and educational encounter.

Most of the serious chronic illness challenges that physicians confront on a daily basis begin and are worsened in private homes behind closed doors. The quality of the practice and the professional potential, of the individuals who embark on the education and then the profession of medicine, are both constantly mediated by the type of patients that health practitioners will see, and the environment in which they will perform the “art” of their practice. Patient mix and environmental demands can present a significant burden to physician motivation, decision making, and professional efficacy and growth. Changing the demands and burdens on physicians that are caused by both patients and payers, administrators and educators, would go a long way towards getting us back to an enjoyable and dignified relationship between persons in need and physicians that can help.

The physician – patient encounter continues to be the central nexus in our healthcare system and it is that encounter that may prove to be most fruitful when we are considering to build a more client centered system that will yield more healthy and sustainable healthy lifestyles. If we intend to keep our treatment systems humane, then we better find ways to support physician decision making and advocacy on behalf of their professional autonomy, their commitment to their professional integrity and to their own well being, and, of course, to the well being of their patients.

The physician – patient encounter can be an important nexus for improving the healthcare learning and treatment experience of healthcare consumers. But it isn’t easy and physicians will not be able to go it alone. Healthcare behavior is perhaps both the most important driver of healthcare costs and of desired healthcare outcomes. It is at once a potential liability and a moderator for escalating costs. And healthcare behavior involves all of us doing our share–both the behavior “actor” as well as all of us who seek to improve and promote healthy lifestyles, health literacy, and just all around good neighborly advice and community quality of life. The RWJ Foundation’s current push for changing local healthcare by promoting and helping to build healthier environments that sustain healthier lifestyles is a start. Physicians need to play a central role in both the continuing evolution and needed conceptualization of such an effort, and the implementation in all the settings where the physician – patient encounter will provide opportunities to teach and support patients in their pursuit of a healthier life.

There are hundreds of physician “types” and roles today, each are shaped by their specialization, their personal motivators for being in the healing and helping business in the first place, and the organizational and business systems in which they practice their craft. As these “supporting” systems change, so do physicians as they are real people with people needs. Our ability to change as sick people needing help is also important. It’s all about change, if the healthcare system changes so can you.

Understanding healthcare system change and knowing how to change to take advantage of the benefits the changing healthcare system offers

The healthcare system is changing and so is the role of the individual who touches and communicates with the person needing healthcare services. The physician – patient encounter is both preceded and surrounded by often conflicting narratives, streams of information, and variables that cause inordinate distraction and preoccupation with things outside of “What is your health problem today and what can I do about it?” Social media and the internet can both help of hinder this important learning and therapeutic relationship. The fulfilled salutary potential in this patient efficacy and health literacy regard remains to be defined and addressed. Physicians can not be all things to all people. We must be creative in evolving the practice environment to bring in roles and technologies that can help both physicians and patients in their predominantly communicative encounter.

In my three decades as a educated health professional and health consumer, and five years in health program implementation, ten years as a health and human services policy advisor, five years as a community health system administrator, I have had the pleasure of looking at the healthcare process from the perspective of just about every imaginable stakeholder. This is even more true in my past ten years, in the public relations and administration areas of behavioral health, in a large policy oversight service payer organization. I have also worked with physicians from every conceivable angle imaginable.

We have seen the role of the physician evolve through and beyond two major national efforts at healthcare reform (during the early 90s with Clinton’s HSA failure, and now with ACA). One could argue that the idyllic role of the “Norman Rockwell” physician continues to be the frame of reference for today’s modern healthcare practitioner and our demands on him/her. Given the evolution of healthcare as a commodity, today’s physician is too often an employee. S/He is certainly an individual equally preoccupied with the challenges of providing effective interventions, as S/He is faced with the plethora of obstacles and challenges surrounding the costly and increasingly evaluated physician – patient encounter today.

Some of these challenges include:

  • The uncertainty and negativity that pervades healthcare today, including preoccupation with costs, competition between the various payers and the patient “recruiting networks,” and the tension between deciding what is needed and what is affordable.
  • The management of pharmaceutical products and information, including how to use those products in the treatment process; and the role of a never ending product cycle that promises to address ever changing patient needs and symptoms.
  • The increasing pace of change in the payer and reimbursement system and the simultaneous challenge of a changing healthcare environment with evolving variables that constantly change the provider’s calculus regarding professional, personal and business risks.
  • The increasing dissemination of health information from multiple sources and the so called “empowerment” of the consumer which can erode (deservedly or not, necessary or not) physician – patient trust and control.

For these and other reasons, practicing medicine today is increasingly less of a one on one, personal experience once driven by laudable helping objectives and noble goals of doing good. Patients enter the physician – patient encounter today with personal and public media marketed fears, agendas, and competing messages in their head.

Physicians, of necessity because of today’s complex primary care process, too often enter that encounter with distractions and pressures from pharmaceutical business, the vicissitudes of insurance reimbursement, and daily business or professional pressures as physicians are also employees, partners or business owners. Today, when you are walking into the physician – patient encounter you could be dealing with a business man, an employee, or a business partner. Each of these roles can significantly mediate the behavior of both attending physician and consuming patient.

We are all in this together. At the end of the day, physicians are real people who also get sick and who ultimately will benefit from you being well. Whether that means less patients in the waiting room and patients that actually followup on the their various recommendations for better health, the important thing is that we go to our doctor’s office with an open mind and a belief that we can help our doctors help us–because we will behave in accordance with their professional advice. This brings up some general ideas regarding the patient’s responsibilities in the physician – patient encounter:

Healthcare change is happening to all of us. Improving our healthcare experience and outcomes will require all of our collective responsibilities in keeping up with the information that will allow us to address how healthcare change affects our specific healthcare needs and how we can improve our communication with our healthcare provider and how we use that communication to live healthier lives.
Just as we expect for physicians to be our advocates we must also be respectful and understanding of their needs as caring professionals performing difficult work that benefits us.
When we make purchasing or political decisions that will impact healthcare policy (whether macro social policy or institutions policies that impact our healthcare), we must always consider that our vote or our healthcare purchase includes the commitment to understanding our responsibility to be informed consumers that can help vet information regarding our needs and to hold both providers and policy makers accountable to protecting our interests and needs.
In the end, we must think of healthcare as a personal behavior issue that begins with how we live our lives and how we take care of ourselves and our loved ones.

Healthcare will always be personal but it will also weigh heavily on our politics and out budgets

After the failure of the early 90s healthcare reform (HSA) and the difficulties with today’s ACA (so called “Obamacare”), what remains is a never ending tension between “Who will pay for this?” and “How can we help people stay healthy so that they don’t incur healthcare costs beyond their economic capacity?” The current RWJ Foundation efforts to invest in transforming the healthcare experience at the community level is a good attempt at favoring the balance towards addressing the second question. Ideally, if we find appropriate answers at the local healthy living level, it will be easier to answer the first question because “Who will pay?” will be addressing a much more manageable bill.

Ask not who will help me pay for my health bill in the first instance, but always ask how will my current lifestyle affect my overall health?

Filed under: News

Emotional Intelligence must not be limited to academic punditry or entrepreneurial conquest … | LinkedIn

EQ Wordle Paul

We can all agree that extremely intelligent people can disagree and sometimes succumb to irrational feelings, misunderstandings and conflict. It is not enough to be smart. It is also important to get along with people, to understand them, and to express ourselves in pleasant ways that help us all get along.

We all at one time or another let our emotions carry us to places we thought we could never reach and some places and situations we never intended to be in. Emotions are an important part of our successes and failures and that includes the emotions that drive the actions of others who impact our journey. It is hard to imagine that learning to manage our emotions and to better understand the emotions of others is not an extremely desirable thing that we can pursue in a straightforward manner. But for many it is not. The concepts that cover this important topic, “emotional literacy” and “emotional competence” can be summarized in the operational definition of emotional intelligence.

Definition of Emotional Intelligence (EQ): “… the subset of social intelligence that involves the ability to monitor one’s own and other’s feelings and emotions, to discriminate among them and to use this information to guide one’s thinking and actions. We posit that life tasks such as those described by Cantor and her colleagues and constructive thinking defined by Epstein are laden with affective information, that this affective information must be processed (perhaps differently than the cognitive information), and that individuals may differ in the skill with which they do so. Emotional intelligence is also a part of Gardner’s view of social intelligence, which he refers to as the personal intelligences. Like social intelligence, the personal intelligences (divided into inter- and intra­ personal intelligence) include knowledge about the self and about others. One aspect of the personal intelligence relates to feelings and is quite close to what we call “emotional intelligence.” John Mayer and Peter Salovey, 1990

Emotional intelligence (also known as “EQ”) is an idea that grew up in academia, was popularized on pop psychology shelves and, more recently, has been made useful in leadership development and organizational management circles. From its conception, it was juxtaposed to the idea of Intelligence Quotient (IQ). Its lofty intellectual beginnings notwithstanding, EQ has been embraced by so many for so many reasons that its early paradigmatic intentions may now be lost to the many.

If the intelligence scale we call “IQ” has been controversial, EQ has been equally misunderstood. Even if we can all agree on a definition and on appropriate applications of EQ theory, it’s behavioral health benefits cannot be implemented through quick short-term programs nor can it’s salutary outcomes be made sustainable without a significant transformation in our health education and K through 12 school educational systems. Many of the individuals, that could benefit from the competencies that learning and having good EQ promises, are neither fortunate enough to access the education nor in social circumstances conducive to self improvement pursuits. In a more mindful and egalitarian world, more complex ideas may achieve greater buoyancy and utility. EQ is no exception.

Popular ideas live in the minds of the many and, perhaps because of their simplicity and utility, become sustainable and prolific for both producers and consumers. The dilemma is, however, that society often needs ideas that are more complex in order to solve and address vexing modern problems. To Goleman’s credit, in part due to his efforts, EQ is being applied through his numerous consulting activities and, for example, in his supportive role helping to organize a set of conferences that led to the publication of a 1997 book by John Mayer and Peter Salovey (Emotional Development and Emotional Intelligence: Educational Implications) addressing possible emotional intelligence and social skills applications to address child development and conflict resolution in school systems (the academic team that initially developed the “theory” that led to EQ as a useful framework for researching and teaching the role that emotions play in achieving personal, social, and organizational success). Aside from this collaboration, though, much of what is popularly understood about EQ has been disseminated through Goleman’s consulting and pop psychology success NYTs best seller style.

Academic ideas and constructs more often tend to be quite different from popular ideas. They differ in that their currency tends to require intellectual specialization, academic environments akin to monasteries, and individuals with a broad understanding of the numerous currents and variables that give academic products their place in the refereed conversation of the nation’s professorial ranks. Emotional intelligence is an important flashpoint for forces with differing origins yet, ideally, common destinations–thinking individuals wanting to promote social good and noble ends. Daniel Goleman and Adam Grant are two such forces; they are social communicative pundits in the ongoing tug of war that will define the proper and productive utility, and place, of emotional intelligence, as a leadership and workforce development concept. According to Grant, Goleman goes too far in trying to apply EQ to business intelligence, heretofore an area reserved for things more mathematical and tangible. Goleman has been given a professional home on the pages of the prestigious Harvard Business Review, an instrument of both Grant and Goleman’s alma matter. A key question would be: Is EQ being misapplied or is the environment where it needs to be applied unready for its heuristic promises? Given the challenges, faced or ignored, by today’s business and organizational leaders, can we afford to dismiss this popular tool?

Adam Grant published a provocative article on LinkedIn formulating a critique of Goleman’s more global approach to EQ. Unfortunately, Grant’s article includes academic claims and posturing that is clouded by his overall trivial tone. We need a greater focus on academic rigor and the pursuit of more robust theoretical constructs that can yield progress towards EQ program development and implementation, in the area of behavioral health, for example. This seriousness seems to be lacking at the present time–certainly in Grant’s article (https://www.linkedin.com/pulse/article/20140930125543-69244073-emotional-intelligence-is-overrated?trk=prof-post).

We may be exceedingly amazed to see academics, intellectuals, pundits, and intellectual entrepreneurs spar, in the marketplace of ideas, in order to promote their worth and place in the market. The debate seems omnipresent as it crosses many borders through the Harvard Business Review, on blogs, and here on LinkedIn. Certainly, Adam Grant steps into the breach and tries to hold Goleman to task for what he sees as academic obfuscation. Interestingly, he borders on ad hominem intentions and plain teasing. Perhaps Adam Grant is pandering to this electronic social media medium and finds such rhetorical tools necessary. Perhaps the conversation that is sought here with leaders understands that today’s leaders are not Plato’s philosopher kings. Indeed, Grant does not seem to see the business of management outside of specific emotional terrain so touchy feely as Goleman would. It is plain to see that Daniel Goleman’s place is secure, as the high priest of pop psychology, because his Ph.D. in Psychology and his perch on the NYTs allowed him to popularly run with the “EQ” concept and build an entrepreneurial empire which may outlive him and the rest of us. To be sure, the spoils from the ensuing popular media endeavors have favored Goleman’s lot, EQ’s intellectual forefathers have not similarly gained (John Mayer and Peter Salovey). This does not bode well for future intellectuals lacking entrepreneurial prowess. You will find Mr. Grant on LinkedIn though, promoting his intellectual wares; he’ll do just fine.

Interestingly, we can look at Salovey’s dissertation from way back in 1986 for the early intellectual ground from which the concept of EQ grew (P. Salovey, The Effects of Mood and Focus of Attention on Self-Relevant Thoughts and Helping Intention, unpublished doctoral dissertation, Yale University, 1986). We can also look at the role of popular psychology in our culture to find similar ground for Goleman’s efforts and success. Mayer and Salovey are the original promoters of the ideas and of the intellectual history which gave intellectual buoyancy to the concept. Daniel Goleman refers to his encounter with the work of these two men in a passing way and diminishes their importance by alluding to the lack of stature of the journal in which they published the original 1990 article “Emotional Intelligence.” Goleman has turned the work of these men into a cottage industry and his published retort to Grant shows his ability to popularly promote the term “EQ” in contrast to feebly defending it. Perhaps Goleman is safe behind the popularity curtain always protecting his wizard like reputation. Up and coming scholar, Adam Grant, rightly exposes Goleman’s use of the concept as less relevant outside the parameters of academic rigor and of the realms of possible scientific discipline and emotive applications. The academic trial only seems to be beginning, though, and the popular court is woefully incapable of sequestering an appropriate jury to reach a useful verdict that would bridge the cerebral gap between academic thinkers, intellectual entrepreneurs and the laboring rank and file. Given EQ’s arguably heuristic potential and the millions that are being made from its application or misapplication, we can’t have some thinking of it as business and the rest of us as “nobody’s business.”

The concept has grown to mean so many things to so many people that it now means specifically very little within the confines of academic, intellectual or theoretical query. Salovey and Mayer’s contributions to modern management and leadership are now popularly distant from their original rigorous work. The popular development of that work may possibly have obstructed the original potential of Salovey and Mayer’s ideas and constructs, further obfuscating the road to needed progressive managerial and leadership applications. Goleman has made it common coin and personal gain–neither being efforts which have contributed significantly in taking the concept further along its original intellectual journey; nor has it helped in the building of necessary theoretical constructs that can give us an applied framework that allows for clarity regarding how and when it is useful as a heuristic model for organizational, group, or individual purposes. To be sure, Goleman now makes these claims; but his arguments are devoid of the rigor evident in the original works of the real pioneers from which the potentially useful constructs originate.

Centuries have passed since the monastic catacombs of the original academy, with its religious literati and the ensuing work of the eventually enlightened philosophers and scientists. That is work that was preserved and discriminatingly shared through coveted books and into modernity. But all that has now changed and continues to change. Academia is only one voice in a cacophony of social and intellectual media now fueled by e-commerce and consumed on billions of instantaneous screens. Ideas are now increasingly, and literally, in the clouds, ubiquitous cannon fodder for daily consumption; their value and retention seems now to be more tethered to the common cause than to the lofty undertaking. Can you imagine that?

More via Emotional Intelligence must not be limited to academic punditry or entrepreneurial conquest … | LinkedIn.

Filed under: Blogosphere, Culture Think, Education Policy, Education Reform, Leadership, Literature & Literati, Mass Media and Public Opinion, Policy ThinkShop Comments on other media platforms, Pundits, Social Media, Using Social Media, WeSeeReason

Ignore Emotional Intelligence at Your Own Risk – Claudio Fernández-Aráoz – Harvard Business Review

Understanding ourselves within the social and psychological context we share with those we interact with every day is vital for success in any social endeavor.  Emotional Intelligence or “EI” is an important theoretical framework for understanding the importance of mastering the motives and passions that we personally embrace and those of others we interact with within the context of working with and through others.  One way of looking at this social context is interpersonal communication.  Another is Emotional Intelligence; which is an important area of human behavior and psychology being developed and practiced by management and human resource gurus today.  The field has matured in terms of leading representatives whose ideas and constructs are grounded not only in sound research but the workshop of practice. This month’s Harvard Business Review has a useful article by Claudio Fernández-Aráoz, a leading practitioner.

“Call it Grant vs. Goleman. Two academic heavyweights face off on a topic that every student of leadership and HR cares — or at least hears — a lot about: emotional intelligence. Wharton professor Adam Grant kicks it off with a LinkedIn blog post, “Emotional Intelligence Is Overrated,” arguing that “it’s a mistake to base hiring or promotion decisions on it” and that “even in emotionally demanding work, when it comes to job performance, cognitive ability still proves more consequential than emotional intelligence.” Daniel Goleman, the psychologist credited with coining the term EI (and, full disclosure, a friend), issues his rebuttal, “Let’s Not Underrate Emotional Intelligence,” questioning the specific assessment of EI used by Grant, and referring to the various studies conducted by “The Consortium for Research on Emotional Intelligence.” And the comments fly.”

More via Ignore Emotional Intelligence at Your Own Risk – Claudio Fernández-Aráoz – Harvard Business Review.

Filed under: access to education, Blogosphere, Culture Think, Pop-Psychology, WeSeeReason

Gap in Diet Quality Between Wealthiest and Poorest Americans Doubles, Study Finds

Healthy food is not easy to prepare, does not have a very long shelf life, and is more expensive than cheaper canned and mass produced “food” that contains fillers and other ingredients that return adequate profits, facilitate transportation, refrigeration, and distribution.

America’s food consumption and health connection problem goes well beyond socioeconomic issues of lack of cash and proximity and access to healthy food.  Our society’s economy produces commodities and commodities are distributed based on market forces of supply and demand.  Supply and demand pressures have thus far overpowered the traditional forces on the side of promoting community health.  The loosing forces are:

  • Social do-gooders
  • Philanthropy
  • Public health officials
  • Conscientious parents
  • Suburban focused and lead prevention efforts

In short, economic forces have thus far trumped social ideas and groups aiming to undo what are basically the macro and micro consequences of food production and distribution.

Any successful efforts in this area will have to have for-profit corporations at the table with philanthropy and government officials providing public policy leadership and incentives that appeal to corporate America’s economic interests and social responsibility (good corporate citizen) commitments.

More via Gap in Diet Quality Between Wealthiest and Poorest Americans Doubles, Study Finds.

Filed under: ACA and Medicaid, Behavioral Health Outcomes, Blogosphere, Health Literacy, Health Policy, Healthcare Reform, News, Parenting, Philanthropy, Policy ThinkShop Comments on other media platforms, Public Health, Public Policy

RWJF Initiative on the Future of Nursing | The information from the experts has been published. What are you and other community stakeholders doing about it?

Are you familiar with the RWJ report titled “The Future of Nursing: Leading Change, Advancing Health” by the Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Penn Medicine (University of Pennsylvania Health System)?

As we know, initiatives like the one that produced this report, as recent as 2011, come and go.  What remains is the report and what committed professional like yourself and our colleagues do with the information.

We at The Policy ThinkShop were inspired by a nurse colleague not only to pullout this report but to post a comment on our blog for your benefit.

The link to the report follows:

http://www.thefutureofnursing.org/sites/default/files/Future%20of%20Nursing%20Report_0.pdf

According to the report:

“In 2008, The Robert Wood Johnson Foundation (RWJF) approached the Institute of Medicine (IOM) to propose a partnership to assess and respond to the need to transform the nursing profession. Recognizing that the nursing profession faces several challenges in fulfilling the promise of a reformed health care system and meeting the nation’s health needs, RWJF and the IOM established a 2-year Initiative on the Future of Nursing. The cornerstone of the initiative is this committee, which was tasked with producing a report containing recommendations for an action-oriented blueprint for the future of nursing, including changes in public and institutional policies at the national, state, and local levels (Box S-1). Following the report’s release, the IOM and RWJF will host a national conference on November 30 and December 1, 2010, to begin a dialogue on how the report’s recommendations can be translated into action. The report will also serve as the basis for an extensive implementation phase to be facilitated by RWJF.”

The report explains the committee of experts charge in producing the study and report as follows:

The committee may examine and produce recommendations related to the following issues, with the goal of identifying vital roles for nurses in designing and implementing a more effective and efficient health care system:

  • Reconceptualizing the role of nurses within the context of the entire workforce, the shortage, societal issues, and current and future technology;
  • Expanding nursing faculty, increasing the capacity of nursing schools, and redesigning nursing education to assure that it can produce an adequate number of well prepared nurses able to meet current and future health care demands;
  • Examining innovative solutions related to care delivery and health professional education by focusing on nursing and the delivery of nursing services; and
  • Attracting and retaining well prepared nurses in multiple care settings, including acute, ambulatory, primary care, long term care, community and public health.

“In 2008, the Robert Wood Johnson Foundation approached the Institute of Medicine (IOM) to propose a partnership between the two organizations. The resulting collaboration became the two-year Robert Wood Johnson Foundation Initiative on the Future of Nursing at the IOM. The committee was chaired by former U.S. Secretary of Health and Human Services Donna Shalala, and the goal was to look at the possibility of transforming the nursing profession to meet the challenges of a changing health care landscape. The report produced by the committee, The Future of Nursing: Leading Change, Advancing Health, makes specific and directed recommendations in the areas of nurse training, education, professional …”

More on the initiative via About | RWJF Initiative on the Future of Nursing.

Filed under: ACA and Medicaid, Blogosphere, Health Literacy, Health Policy, Healthcare Reform, Leadership, Maternal and Child Health, News, Philanthropy, Policy ThinkShop Comments on other media platforms, Public Health, Public Policy,

Creativity and the Role of the Leader – Harvard Business Review

The folks at the Harvard Business Review recently convened a large group of highly motivated and intelligent individuals to discuss and promote best practices in the area of fostering creativity at work and the role of leadership in doing so.

Although we sometimes feel that our work environments demand so much focus on ongoing deadlines and desired outcomes that there is little time for stepping back and reflecting, taking chances on new ideas or even finding time to discuss and contemplate alternatives can be possible.   It’s nice to see that leading thought places like HBR are promoting initiatives, concepts and activities in the workplace that allow for consideration of priorities that include some of our most intimate personal needs.  These needs include our ability to think and contribute in creative ways; which is ideal for us in terms of our careers and self actualization, and for the organizations we work to improve.

The article in HBR addresses important conditions for allowing creativity to flow in the workplace:

“Three conditions seemed to him to be necessary for novelty—slack, hubris, and optimism …”

via Creativity and the Role of the Leader – Harvard Business Review.

Filed under: Blogosphere, Culture, Culture Think, , ,

Getting Cross-Cultural Teamwork Right | HBR Article Policy ThinkShop Review

Cultural diversity and cultural conflict at the workplace are often treated as simple communication problems.  Are we oversimplifying cross cultural communication? Is it more than just being patient and trying to be nice? This HBR article opens an important conversation …. What do you think?

Although I think that articles like this one begin to give us the ideas, examples and interpersonal communicative behaviors necessary for navigating intercultural communication and interaction, I do think we need to acknowledge the role of leadership and power relationships.

For example, when two individuals are having conflict based on communication issues alone, this sort of cross-cultural relationship management works well. However, cross-cultural and international collaborations are difficult for the same reasons that all business collaborations are hard; they are challenging because there are competing agendas, whether these be interpersonal (personal career considerations) or inter organizational (each organization has a particular agenda and value expectations regarding the collaboration).

When we interact as individuals on our “home company” team’s behalf, we are performers on that team and our participation impacts how well we do back home; where, after all, is where we get our bonuses, our reputations, and how we are measured regarding home company people we naturally complete with.

Also, the cultural interaction abroad is greatly colored by power relationships of differing status; for example, when they are either asymmetrical, equal or of longer or shorter duration.

Cross cultural communication is quite complex–often, the challenges of cultural dissonance are relatively minor when we take into account the many variables that drive human behavior, interpersonal communication, and context variables that drive business motivation and goals.

Read the article and see the Policy ThinkShop comments by Paul

http://blogs.hbr.org/2014/09/getting-cross-cultural-teamwork-right/

via Welcome! | LinkedIn.

Filed under: Blogosphere, Culture Think,

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