Guest guest Posted October 17, 2011 Report Share Posted October 17, 2011 Your Weekly Posterous Spaces Update October 17th, 2011 Steps you can take to prevent developing diabetes<http://ptmanagerblog.com/steps-you-can-take-to-prevent-developing-diab> Posted 3 days ago by [image: _portrait_thumb] Kovacek, PT, DPT, MSA <http://posterous.com/people/1l1oCkDWEWjv> to PTManager<http://ptmanagerblog.com> [image: Like this post]<http://posterous.com/likes/create?post_id=75443840> Steps you can take to prevent developing diabetes http://www.kevinmd.com/blog/?p=60005 In the past decade, the incidence of diabetes<http://www.kevinmd.com/blog/2011/08/educated-online-people-diabetes.htm\ l>in the U.S. has nearly doubled – this is due in large part to the obesity epidemic. Currently, it is estimated that the lifetime risk of developing diabetes is around 1 in 3 for males an 2 in 5 for females born after 2000. When you consider that type II diabetes has a strong genetic component – the risk for a child with two type II diabetic parents jumps to 50% – the odds are really stacked against us. Thankfully, there is an environmental component to the disease process, and there are steps you can take to prevent developing diabetes. *1. ** Stop smoking.* Diabetes is increasingly recognized as a disease with a vascular component. Most of the complications that develop in diabetics are a direct result of small and large vessel disease – vision loss, kidney damage, heart attack, stroke. Smoking only accelerates vascular damage, and by quitting, you ease the workload on your heart and lungs and lower several down-stream risk factors for heart disease and stroke. It’s also been shown that diabetics have decreased antioxidant capacity, and quitting cigarettes (or never starting) will lower your free radical burden – also important in vascular disease. *2. Lose weight.* According tot he Diabetes Prevention program, an NIH-funded study, weight loss may be the single most beneficial lifestyle change to reduce your risk of developing type II diabetes. Even if you have much more to lose, 10-15 pounds of weight loss can make a difference. *3. Stay active.* Besides helping maintain a health weight and decreasing your overall risk of dying, exercising improves your insulin sensitivity – one of the key components of the pathogenesis of diabetes. Additionally, research shows that exercise helps to reduce your risk for other conditions like stroke, heart disease, osteoporosis, and even Alzheimer’s. If you have been inactive for a long period of time, “start low and go slow” – and speak with your doctor before beginning a new exercise program. *4. Improve your diet.* I’ve had my issues with the USDA’s diet recommendations<http://abnormalfacies.wordpress.com/2011/06/07/usda-dumps-food-p\ yramid/>over the years, but eating healthy doesn’t have to be confusing – and a diet to lower your risk of diabetes is a real no-brainer. In general, cut back on soda, sweets, and processed foods; include whole grains, fish, and a variety of fruits and vegetables – and remember the importance of portion control. When grocery shopping, make a list and try to stick to it – and use my guide to navigating the supermarket<http://abnormalfacies.wordpress.com/2011/03/11/tips-for-navigating-t\ he-supermarket/>to help you make better choices. *5. Understand your risk. *Familiarizing yourself with your risk factors for developing diabetes not only serves as a reminder to make better choices, but may also allow you to nip pre-diabetes in the butt and avoid a visit to the emergency department like the gentleman above. Risk factors for pre-diabetes and diabetes, in addition to obesity & inactivity, include the following: - having a first-degree relative with diabetes - being older than 45 - certain ethnicities – African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, or Pacific Islander - having high blood pressure (>140/90 mmHg) or being treated for high blood pressure (something I commonly hear from patients is “I had high blood pressure, but not anymore because I take medicine”) - having low HDL (<35 mg/dL) or high triglycerides (>250 mg/dL) - having impaired fasting glucose (IFG) or impaired glucose tolerance (IGT) on previous testing by your doctor - having other conditions associated with insulin resistance, such as polycystic ovary syndrome (PCOS) or gestational diabetes - having a history of cardiovascular disease When your doctor says you have pre-diabetes, it means your chances of developing overt type II diabetes is significantly increased. Know the signs & symptoms that diabetes presents with so that you can seek care before serious complications develop: frequent trips to the bathroom or excessive urination, increasing thirst, weakness & fatigue, numbness or tingling in the hands and feet, and blurred vision are common complaints. If you have any questions about diabetes and your personal risk, don’t be afraid to ask your doctor. If you don’t have a personal doctor, try to take advantage of community screenings and local health fairs – it’s even more important to protect yourself if you don’t receive regular medical care. * Haddad is a medical student who blogs at *Abnormal Facies<http://abnormalfacies.wordpress.com/> *.* * **Submit a guest post and be heard<http://www.kevinmd.com/blog/heard-social-medias-leading-physician-voice>on social media’s leading physician voice. * via kevinmd.com<http://www.kevinmd.com/blog/2011/10/steps-prevent-developing-diabete\ s.html> This is something we should be sharing with each and every patient we see. Physical therapy direct access effective - UPI.com<http://ptmanagerblog.com/physical-therapy-direct-access-effective-upic> Posted 2 days ago by [image: _portrait_thumb] Kovacek, PT, DPT, MSA <http://posterous.com/people/1l1oCkDWEWjv> to PTManager<http://ptmanagerblog.com> [image: Like this post]<http://posterous.com/likes/create?post_id=75563485> Physical therapy direct access effective Published: Oct. 14, 2011 at 10:35 PM Comments (0) Email Print Listen Embedded media -- click here to see it.<http://ptmanagerblog.com/physical-therapy-direct-access-effective-upic> Embedded media -- click here to see it.<http://ptmanagerblog.com/physical-therapy-direct-access-effective-upic> IOWA CITY, Iowa, Oct. 14 (UPI) -- Patients making appointments to a physical therapist without a physician's referral may experience lower costs and make fewer visits, U.S. researchers suggest. Study leader Jane Pendergast, director of the Center for Public Health Studies at the University of Iowa, and colleagues analyzed five years of private health insurance claims -- 2003 to 2007 -- involving nearly 63,000 outpatient physical therapy data from a Midwest insurer on beneficiaries ages 18-64 in Iowa and South Dakota. More than 45,000 were classified as physician-referred if the patient had a physician claim from a reasonable referral source in the 30 days before the start of physical therapy. More than 17,000 were classified as " self-referred " to physical therapists. The study, published in the journal Health Services Research, found self-referred patients had fewer physical therapy visits and lower allowable amounts during the episode of care, after adjusting for age, gender, diagnosis, illness severity and calendar year. In addition, overall related healthcare use -- care related to the problem for which physical therapy was received, but not physical therapy treatment -- was lower in the self-referred group. " Our findings do not support the assertion that self-referral leads to overuse of care or discontinuity in care, based on a very large population of individuals in a common private health insurance plan with no requirement for physical therapy referral or prohibition on patient self-referral, " the study authors said in a statement. via upi.com<http://www.upi.com/Health_News/2011/10/14/Physical-therapy-direct-access\ -effective/UPI-87861318646147/?spt=hs & or=hn> Humana Reverses MPPR Payment Methodology<http://ptmanagerblog.com/humana-reverses-mppr-payment-methodology> Posted 1 day ago by [image: _portrait_thumb] Kovacek, PT, DPT, MSA <http://posterous.com/people/1l1oCkDWEWjv> to PTManager<http://ptmanagerblog.com> [image: Like this post]<http://posterous.com/likes/create?post_id=75603631> Humana Reverses MPPR Payment Methodology Physical therapists who returned payments to Humana following the implementation of its multiple procedure payment reduction (MPPR) policy should soon receive refunds from the insurer. Without advanced notice to providers, Humana implemented MPPR for therapy services, effective January 1, based on the methodology used by Medicare for the physician fee schedule. However, Humana did not have an automatic process in place to adjudicate claims correctly based on this methodology. In addition, Humana failed to implement its MPPR policy on January 1; rather it implemented the policy retroactively, sending payment recovery letters to physical therapists requesting refunds for overpayment of claims this summer. APTA contacted Humana to obtain additional clarification and was informed that the insurer will refund monies recouped from physical therapists, as the recovery attempts were invalid. Physical therapists should expect to see refunds from Humana within the next 30 days. It is important to note that Humana will continue to review the MPPR payment methodology and may consider it for future changes to payment. via apta.org <http://www.apta.org/PTinMotion/NewsNow/2011/10/14/Humana/> UnitedHealthcare® Announces Multiple Therapy Reduction Policy<http://ptmanagerblog.com/unitedhealthcare-announces-multiple-therapy-r> Posted 1 day ago by [image: _portrait_thumb] Kovacek, PT, DPT, MSA <http://posterous.com/people/1l1oCkDWEWjv> to PTManager<http://ptmanagerblog.com> [image: Like this post]<http://posterous.com/likes/create?post_id=75603649> UnitedHealthcare® Announces Multiple Therapy Reduction Policy Modeled after the multiple procedure payment reduction policy implemented by the Centers for Medicare and Medicaid Services, UnitedHealthcare (UHC) will implement a new multiple therapy reduction policy on physical medicine and rehabilitation services effective March 1, 2012. The October 2011 OptumHealth physical health provider newsletter provides details on the multiple therapy reduction policy, which will apply to UHC claims only. UHC's intent is to use the code with the highest practice expense value as the primary procedure. OptumHealth is evaluating the policy and will notify its providers in a future newsletter if it will be implemented in OptumHealth systems. The policy does not apply to providers contracted at a flat rate per diem payment methodology. OptumHealth's physical health provider newsletter is available online for contracted providers through its member-protected Web site. The bulletin will be available online in November through UHC's Web site and will be accessible to providers both in and out of network (OON). This will give OON providers advanced notice prior to implementation. APTA will submit a letter of comment to UHC. via apta.org<http://www.apta.org/PTinMotion/NewsNow/2011/10/14/UnitedHealthcare/> Former Board of Directors Member and Section Leader Jane Walter Venzke Dies <http://ptmanagerblog.com/former-board-of-directors-member-and-section> Posted 1 day ago by [image: _portrait_thumb] Kovacek, PT, DPT, MSA <http://posterous.com/people/1l1oCkDWEWjv> to PTManager<http://ptmanagerblog.com> [image: Like this post]<http://posterous.com/likes/create?post_id=75604025> Friday, October 14, 2011[image: RSS Feed]<http://www.apta.org/rssfeed.aspx?blog=10737418615> Former Board of Directors Member and Section Leader Jane Walter Venzke Dies *Jane Walter Venzke, PT, EdD, FAPTA*, age 66, of Concord, New Hampshire, died October 8 after a long illness. Venzke was a long-time member of APTA and served as president of the New Hampshire Chapter and the Education Section. She also served on APTA's Board of Directors, including as vice president. In 1981 she was appointed by President Reagan to the White House Conference on Aging and to membership of the National Arthritis Advisory Board. Venzke credited these 2 national appointments as her introduction to the politics of public policy. Venzke's career in academia, her membership with various Lebanon, New Hampshire, groups, and her wishes for donations are detailed in the *Concord Monitor*<http://www.legacy.com/obituaries/concordmonitor/obituary.aspx?n=jane-wa\ lter-venzke-pt-edd-fapta & pid=154039935 & fhid=4684> *.* ** via apta.org <http://www.apta.org/PTinMotion/NewsNow/2011/10/14/Venzke/> Jane was a wonderful friend, mentor and person. I will miss her every day. RIP Here's how to spot Medicare fraud | Detroit Free Press | freep.com<http://ptmanagerblog.com/heres-how-to-spot-medicare-fraud-detroit-free\ > Posted about 15 hours ago by [image: _portrait_thumb] Kovacek, PT, DPT, MSA <http://posterous.com/people/1l1oCkDWEWjv> to PTManager<http://ptmanagerblog.com> [image: Like this post]<http://posterous.com/likes/create?post_id=75727320> Here's how to spot Medicare fraud [image: Huggins] Huggins BY PATRICIA ANSTETT DETROIT FREE PRESS HEALTH WRITER While looking for a job, Huggins is using his free time to help Detroit senior citizens learn how to spot Medicare fraud. He tells them to find a safe place for their Medicare card and to tuck it away. And he wants them -- or a trusted friend or family member -- to review all statements from the program to be sure they haven't been billed for care they never got. " I tell people if they don't understand it, get someone else to read it, " he said of the billing statements. Huggins, 58, of Detroit, is a laid-off human resources administrator for an automotive supplier. He was trained as a Senior Medicare Patrol volunteer in May by Detroit's Area Agency on Aging, a nonprofit group that is part of a national network that helps seniors with Medicare issues. Medicare also has expanded its Web site to help people spot fraud. Some tips: • Do not let anyone borrow or pay to use your Medicare ID card or your identity. It's illegal, and it's not worth it. Treat your Medicare and Social Security numbers the way you would a credit card. • Be suspicious of anyone who offers you free medical equipment or services and then requests your Medicare number. If it's free, they don't need your number. • Check the Medicare summary notices and your medical bills carefully. If you see anything questionable, call your doctor or health plan. • To report fraud, call the U.S. Office of Inspector General -- -- or go to www.stopmedicarefraud.gov. • Be suspicious of doctors, health care providers or suppliers who do any of these things: use telephone or door-to-door selling techniques. Bill Medicare for services you never received or a diagnosis you do not have. Offer nonmedical transportation or housekeeping as Medicare-approved services. Bill home health services for patients who are not confined to their home, or for patients who still drive a car. Bill Medicare for medical equipment for people in nursing homes. via freep.com<http://www.freep.com/article/20111016/FEATURES08/110160404/Here-s-how-\ spot-Medicare-fraud> Why Annual Performance Reviews Are A Waste Of Time<http://ptmanagerblog.com/why-annual-performance-reviews-are-a-waste-of> Posted about 2 hours ago by [image: _portrait_thumb] Kovacek, PT, DPT, MSA <http://posterous.com/people/1l1oCkDWEWjv> to PTManager<http://ptmanagerblog.com> [image: Like this post]<http://posterous.com/likes/create?post_id=75805617> Why Annual Performance Reviews Are A Waste Of Time By F. Reh <http://management.about.com/bio/F--Reh-229.htm>, About.com Guide *Why Annual Performance Reviews Are A Waste Of Time* How many times have you had to stop doing something important just to fill out an employee's annual performance evaluation? How often was that because somebody from Human Resources was bugging you for it? Or the employee was reminding you, because their raise depended on it? *Wrong Reasons* Those are certainly the most common reasons why we make time for them. Sometimes a sense of obligation or a good secretary's reminder triggers it. None of those are valid reasons for doing an annual performance evaluation, yet that's why most of us do them. *Right Reasons* Did you ever think, " If I don't get all of my employees' annual reviews done on time this year my boss may hold it against me on MY annual review " ? That is a better reason, but I'll bet it never happened. How about doing it because " I may be able to help an employee improve his or her performance " ? I'll bet that doesn't happen as often as hauling someone into your office and chewing them out or walking out to somebody's cubicle and congratulating them on getting the project done ahead of time. *And that is my point. ANNUAL performance reviews are a waste of time because they are too infrequent*. You see it yourself in your own review. Your boss doesn't mention whether or not you got all of your employees' annual reviews done on time, because. usually, it happened so long ago he doesn't remember. And neither do you for that matter. *So What's Better* Well, more frequent is better. And less formal is better. Better for both you and the employee. If you have to do formal reviews, do them quarterly. Most of us can actually remember what has happened over the last three months. Be sure to spend less than a quarter of the time doing them that you would have for an annual review. Then when you have to do an annual review you can just review the past three months and tack on the three previous quarterly reviews. The best performance review is the ongoing review. Work with your employees on how they are doing on a task by task basis - daily or weekly. Let them know right away what they are doing wrong so they can correct it now, not twelve months from now when it has become an ingrained habit. Be sure to also point out the things they are doing well. Remember, we all like praise. Remember too that if you neglect to tell them that something they are doing is right, they may not realize it and they may change it. *Skip the Formality* The other benefit to doing frequent (continual) performance evaluations is that they become less formal. Neither you nor the employee feels stressed about it. This can eliminate the kinds of extreme behavior that we read about when an employee, who has been reprimanded, goes home gets his gun and comes back to the office and shoots his boss, several coworkers, and himself. ------- If you have any questions or comments about this article, or if there is an issue you would like us to address, please post them on our Management Forum<http://forums.about.com/ab-management/start?lgnf=y>to share with the entire group. *More Management Feature Articles*<http://management.about.com/library/weekly/mpreviss.htm> Suggested Reading - The Annual Review. Maximize the benefits of this required time waster<http://management.about.com/cs/peoplemanagement/a/aa032703.htm> - Performance Management Instead of Layoffs<http://management.about.com/library/weekly/aa072301.htm> - Conflict Resolution & Workplace Violence<http://management.about.com/cs/conflictres/> New posts to the Management forums<http://forums.about.com/ab-management/start/?lgnF=y> : - HRM<http://forums.about.com/dir-app/acx/ACDispatch.aspx?action=message & webtag=ab\ -management & msg=1974> - EFFECTIVE MANAGEMENT<http://forums.about.com/dir-app/acx/ACDispatch.aspx?action=message & we\ btag=ab-management & msg=1973> - Frustrated<http://forums.about.com/dir-app/acx/ACDispatch.aspx?action=message & we\ btag=ab-management & msg=1972> New posts to the Management forums<http://forums.about.com/ab-management/start/?lgnF=y> : - HRM<http://forums.about.com/dir-app/acx/ACDispatch.aspx?action=message & webtag=ab\ -management & msg=1974> - EFFECTIVE MANAGEMENT<http://forums.about.com/dir-app/acx/ACDispatch.aspx?action=message & we\ btag=ab-management & msg=1973> - Frustrated<http://forums.about.com/dir-app/acx/ACDispatch.aspx?action=message & we\ btag=ab-management & msg=1972> Related Articles - The Annual Review. Maximize the benefits of this required time waster<http://management.about.com/cs/peoplemanagement/a/aa032703.htm> - Should I Do An Annual Performance Review On My Employees?<http://management.about.com/od/frequentlyaskedquestions/f/Should-I-Do\ -An-Annual-Performance-Review-On-My-Employees.htm> - Performance Evaluations - Human Resource Management<http://www.netplaces.com/human-resource-management/employee-retention\ /performance-evaluations.htm> - Employee Performance Reviews - How to Prepare for a Performance Review and ...<http://careerplanning.about.com/od/performancereview/a/reviews.htm> - Performance Evaluation Structures - Managing People<http://www.netplaces.com/managing-people/performance-standards-and-evalua\ tion/performance-evaluation-structures.htm> via management.about.com<http://management.about.com/cs/people/a/PerfRvwWaste.htm> Get Rid of the Performance Review!<http://ptmanagerblog.com/get-rid-of-the-performance-review> Posted about 2 hours ago by [image: _portrait_thumb] Kovacek, PT, DPT, MSA <http://posterous.com/people/1l1oCkDWEWjv> to PTManager<http://ptmanagerblog.com> [image: Like this post]<http://posterous.com/likes/create?post_id=75805712> By SAMUEL A. CULBERT<http://online.wsj.com/article_email/SB122426318874844933-lMyQjAxMTIxMjE0\ NDIxNjQzWj.html#> You can call me " dense, " you can call me " iconoclastic, " but I see nothing constructive about an annual pay and performance review. It's a mainstream practice that has baffled me for years. To my way of thinking, a one-side-accountable, boss-administered review is little more than a dysfunctional pretense. It's a negative to corporate performance, an obstacle to straight-talk relationships, and a prime cause of low morale at work. Even the mere *knowledge* that such an event will take place damages daily communications and teamwork. [image: video] <http://online.wsj.com/article_email/SB122426318874844933-lMyQjAxMTIxMjE0NDIxNjQ\ zWj.html#> Tips on Dealing with a Poor Performer<http://online.wsj.com/article_email/SB122426318874844933-lMyQjAxMTIxMj\ E0NDIxNjQzWj.html#> 4:00 UCLA professor, Culbert, shares some managerial tips on improving an employee's performance. (Oct. 20) The alleged primary purpose of performance reviews is to enlighten subordinates about what they should be doing better or differently. But I see the primary purpose quite differently. I see it as intimidation aimed at preserving the boss's authority and power advantage. Such intimidation is unnecessary, though: The boss has the power with or without the performance review. And yes, I have an alternative in mind that will get people and corporations a great deal more of what they actually need. To make my case, I offer seven reasons why I find performance reviews ill-advised and bogus. Handling a Bad Review - *JOURNAL PODCAST*:<http://podcast.mktw.net/wsj/audio/20081020/pod-wsjjrculbert/pod-wsjjrc\ ulbert.mp3>How should an employee deal with a negative performance review, both during and after the meeting? Culbert talks with White. Join the Discussion - *JOIN THE DISCUSSION:* <http://forums.wsj.com/viewtopic.php?t=4304> Do you agree that performance reviews do more harm than good? What effects have you seen in your company? What would you suggest that reviews be replaced with? Share your thoughts in an online forum with Culbert. The Journal Report [image: [The Journal Report: Business Insight]]<http://online.wsj.com/public/page/0_0_WZ_0_0228.html> <http://online.wsj.com/public/page/0_0_WZ_0_0228.html> - See the complete Business Insight<http://online.wsj.com/public/page/0_0_WZ_0_0228.html>report. TWO PEOPLE, TWO MIND-SETS Let's start with an obvious reason: The mind-sets held by the two participants in a performance review work at cross-purposes. The boss wants to discuss where performance needs to be improved, while the subordinate is focused on such small issues as compensation, job progression and career advancement. The boss is thinking about missed opportunities, skill limitations and relationships that could use enhancing, while the subordinate wants to put a best foot forward believing he or she is negotiating pay. All of this puts the participants at odds, talking past each other. At best, the discussion accomplishes nothing. More likely, it creates tensions that carry over to their everyday relationships. Then there are second-order problems. A subordinate who objects to a characterization of faults runs the risk of adding another to the boss's list: " defensiveness and resistance to critique. " And the boss who gets her mind turned around by a subordinate's convincing argument runs the risk of having a bigger boss think she failed to hold the line on what had been decided and budgeted. Good luck to her when she next gets evaluated. PERFORMANCE DOESN'T DETERMINE PAY Another bogus element is the idea that pay is a function of performance, and that the words being spoken in a performance review will affect pay. But usually they don't. I believe pay is primarily determined by market forces, with most jobs placed in a pay range prior to an employee's hiring. Raises are then determined by the boss, and the boss's boss, largely as a result of the marketplace or the budget. The performance review is simply the place where the boss comes up with a story to justify the predetermined pay. If the raise is lower than the subordinate expects, the boss has to say, " We can work to get it higher in the future, and here are the things you need to do to get to that level. " Or the boss can say, " I think you walk on water, but I got push-back from H.R. and next year we'll try again. " [image: [The Journal Report: Business Insight]] Ross Mac In other words, too many lines spoken in a performance review are a cover story for the truth and have little to do with performance. Even when it's a positive review, the words spoken are likely to be aimed more at winning the subordinate's gratitude than at providing a candidly accurate description. OBJECTIVITY IS SUBJECTIVE Most performance reviews are staged as " objective " commentary, as if any two supervisors would reach the same conclusions about the merits and faults of the subordinate. But consider the well-observed fact that when people switch bosses, they often receive sharply different evaluations from the new bosses to whom they now report. To me, this is just further proof that claiming an evaluation can be " objective " is preposterous, as if any assessment is independent of that evaluator's motives in the moment. Missing are answers to questions like, " As seen by whom? " and " Spun for what? " Implying that an evaluation is objective disregards what everyone knows: Where you stand determines what you see. The absurdity is even more obvious when bosses -- as they so often do -- base their reviews on anonymous feedback received from others. This illogic is highlighted in the contemporary performance-reviewing fad called " 360-degree feedback. " Hate mail, I suppose, is similarly " objective. " People are told, " I can't tell you who said this, " as if the alleged truth-teller has no ax to grind and the allegation is unrelated to a specific motive or a disagreement in a relationship. Come on! Isn't " anonymous " just a slicker way for people to push what's in their political interests to establish, without having their biases and motives questioned? Lessons in Leadership<http://online.wsj.com/public/page/lessons-in-leadership.html> A leadership guide featuring step-by-step how-tos, Wall Street Journal stories and video interviews with CEOs. What will it take for people to really understand that any critique is as much an expression of the evaluator's self-interests as it is a subordinate's attributes or imperfections? To my way of thinking, the closest one can get to " objective " feedback is making an evaluator's personal preferences, emotional biases, personal agendas and situational motives for giving feedback sufficiently explicit, so that recipients can determine what to take to heart for themselves. ONE SIZE DOES NOT FIT ALL Employees all come with their own characteristics, strong suits and imperfections that they orchestrate in every attempt to perform their best. Because no two people come similarly equipped, they draw upon the unique pluses and minuses they were endowed with at birth along with compensatory assets they subsequently developed. Failing Grade - *The Promise:* Performance reviews are supposed to provide an objective evaluation that helps determine pay and lets employees know where they can do better. - *The Problems:* That's not most people's experience with performance reviews. Inevitably reviews are political and subjective, and create schisms in boss-employee relationships. The link between pay and performance is tenuous at best. And the notion of objectivity is absurd; people who switch jobs often get much different evaluations from their new bosses. - *The Solution:* Performance previews instead of reviews. In contrast to one-side-accountable reviews, performance previews are reciprocally accountable discussions about how boss and employee are going to work together even more effectively than they did in the past. Previews weld fates together. The boss's skin is now in the game. And yet in a performance review, employees are supposed to be measured along some predetermined checklist. In almost every instance what's being " measured " has less to do with what an individual was focusing on in attempting to perform competently and more to do with a checklist expert's assumptions about what competent people do. This is why pleasing the boss so often becomes more important than doing a good job. Create a positive impression and the boss will score you high on any dimension presented. Worse, bosses apply the same rating scale to people with different functions. They don't redo the checklist for every different activity. As a result, bosses reduce their global sentiments to a set of metrics that captures the unique qualities of neither the person nor the job. Maybe, for instance, there's a guy who doesn't voice his viewpoint when he disagrees with something said. Does that mean he should be graded down for being a conflict-avoider -- as if the boss's in-your-face way of communicating is superior? He may be seen as doing a bad job based solely on an incompatibility of styles that may have little to do with actual performance. PERSONAL DEVELOPMENT IS IMPEDED The drive for improvement goes on in big and little ways at work. You would think that the person in the best position to help somebody improve would be his or her boss. Yet, thanks to the performance review, the boss is often the last person an employee would turn to. Why is that? The No. 1 reason for that reluctance is that employees want to turn to somebody who understands their distinctive talents and way of thinking, or knows them sufficiently well to appreciate the reasons behind the unique ways they are driven to operate. By contrast, people resist help from those who they believe can't get them in proper focus, especially when they have tried on many occasions to tell them. What's more, people don't want to pay a high price for acknowledging their need for improvement -- which is exactly what they would do if they arm the boss with the kind of personal information he or she would need to help them develop. It could all come back to haunt them in the performance review. No wonder the developmental discussions the boss wants to inject at the time of a performance review so often get categorized by subordinates as gun-to-the-head intimidation requiring false acquiescence, lip-service agreement and insincere, appearance-correcting actions. DISRUPTION TO TEAMWORK Managers can talk until they are blue in the face about the importance of positive team play at every level of the organization, but the team play that's most critical to ensuring that an organization runs effectively is the one-on-one relationship between a boss and each of his or her subordinates. The performance review undermines that relationship. That's because the performance review is so one-sided, giving the boss all the power. The boss in the performance review thinks of himself or herself as the evaluator, and doesn't engage in teamwork with the subordinate. It isn't, " How are we going to work together as a team? " It's, " How are you performing for me? " It's not our joint performance that's at issue. It's the employee's performance that's a problem. All of which leads to inauthentic behavior, daily deception and a ubiquitous need for subordinates to spin all facts and viewpoints in directions they believe the boss will find pleasing. It defeats any chance that the boss will hear what subordinates actually think. Here's a simple example: In a performance review, the boss cites a subordinate's missing a high-profile meeting as cause for a reduced rating. What if the reason was something personal -- perhaps a son picked up by the police -- that the employee doesn't want to reveal? Why not reveal it? Because one-way accountability inevitably creates distrust. Does the boss self-reflect and ask, " What did I do, or should I be doing, to build up the trust? " No, the boss faults the guy for secretiveness. It's a vicious cycle. For Further Reading See these related articles from MIT Sloan Management Review. - *Building Competitive Advantage Through People* *By A. Bartlett and Sumantra Ghoshal (Winter 2002)* Today's scarce, sought-after strategic resource is expertise, which comes in the form of employees. http://sloanreview.mit.edu/smr/issue/2002/winter/3/ - *Rethinking the 'War for Talent'* *By Deepak Somaya and Ian O. on (Summer 2008)* An implicit assumption of the " war for talent " perspective is that departing workers are lost to competitors. Yet employees also leave to join " cooperators. " http://sloanreview.mit.edu/smr/issue/2008/summer/02/ - *How Consistent Are Performance Review Criteria?* *By Gwynne (Summer 2002)* Managers in the same company frequently use different criteria to review their employees' work -- unless the organization has trained them to do otherwise. http://sloanreview.mit.edu/smr/issue/2002/summer/1f/ - *Why Leadership-Development Efforts Fail* *By A. Ready and Jay A. Conger (Spring 2003)* Investments in developing leaders have often failed the companies seeking to create a pipeline of leaders. http://sloanreview.mit.edu/smr/issue/2003/spring/11/ - *Strategies for Preventing a Knowledge-Loss Crisis* *By Salvatore Parise, Rob Cross and H. Davenport (Summer 2006)* When employees leave an organization, they depart with more than what they know; they also leave with critical knowledge about who they know. http://sloanreview.mit.edu/smr/issue/2006/summer/09/ IMMORALITY OF JUSTIFYING CORPORATE IMPROVEMENT I believe it's immoral to maintain the facade that annual pay and performance reviews lead to corporate improvement, when it's clear they lead to more bogus activities than valid ones. Instead of energizing individuals, they are dispiriting and create cynicism. Instead of stimulating corporate effectiveness, they lead to just-in-case and cover-your-behind activities that reduce the amount of time that could be put to productive use. Instead of promoting directness, honesty and candor, they stimulate inauthentic conversations in which people cast self-interested pursuits as essential company activities. The net result is a resource violation, and I think citations should be issued. If it's a publicly held company, shareholder value gets decreased. If it's a governmental organization, time is lost that could be spent in pursuit of the public good. And what participants learn in the process has more to do with how to survive than with meaningful self-development. I've often thought that every organization should be considered partially a public entity since they exist, in part, to provide meaningful activities for the people who work in them. Skills and mind-sets acquired at work go home with people to affect family, community, culture and even the world. The more positive an atmosphere we can create at work, the more positive an impact it has at home. In short, what goes around comes around. SO, WHAT'S THE ALTERNATIVE? The alternative to one-side-accountable, boss-administered/subordinate-received performance *reviews* is two-side, reciprocally accountable, performance *previews*. Let me explain. The boss's assignment is to guide, coach, tutor, provide oversight and generally do whatever is required to assist a subordinate to perform successfully. That's why I claim that the boss-direct report team should be held jointly accountable for the quality of work the subordinate performs. I'm sick and tired of hearing about subordinates who fail and get fired, while bosses, whose job it was to ensure subordinate effectiveness, get promoted and receive raises in pay. Holding performance previews eliminates the need for the boss to spout self-serving interpretations about what already has taken place and can't be fixed. Previews are problem-solving, not problem-creating, discussions about how we, as teammates, are going to work together even more effectively and efficiently than we've done in the past. They feature descriptive conversations about how each person is inclined to operate, using past events for illustrative purposes, and how we worked well or did not work well individually and together. The preview structure keeps the focus on the future and what " I " need from you as " teammate and partner " in getting accomplished what we both want to see happen. It doesn't happen only annually; it takes place each time either the boss or the subordinate has the feeling that they aren't working well together. Realistic assessment of someone's positive qualities requires replacing scores on standardized checklists with inquiry. As a result, step No. 1 in giving effective feedback almost always involves " active questioning " inquiry. Inquiry contrasts with most performance reviews, which begin with how the evaluator sees the individual and what that boss has already decided most needs enhancing. Both participants need an answer to the most significant issue at hand: " Given who I am and what I'm learning about this other individual, what's the best way for us to complement one another in getting work accomplished with excellence? " If in the process the other person decides to change and develop, so much the better. Bosses should be asking all the questions that occur to them in inquiring about how a subordinate thinks he or she can best perform the job. Then, after they have exhausted their questions, they should ask the subordinate for what else they need to know. At a minimum, they should be asking " How will you be going about it? " and " Specifically, what help do you need from me? " Why not get it all when, at the end of the day, the boss still has the authority to play ultimate decider? Some of you may also ask if the performance review goes away, how do we prepare the groundwork if we want to fire somebody? For the better, I'd argue: Take away the performance review, and people will find more direct ways of accomplishing that task. Substituting performance previews for performance reviews promotes straight-talk relationships for people who are up to it. It welds fates together because the discussion will be about what the boss-subordinate team accomplishes together, which I believe is the valid unit to hold accountable. It's the boss's responsibility to find a way to work well with an imperfect individual, not to convince the individual there are critical flaws that need immediate correcting, which is all but guaranteed to lead to unproductive game playing and politically inspired back-stabbing. There are many bosses who would like to change that game, but they feel handcuffed by the rules already in play. I'd like to believe that if given the chance, they would embrace a system that allows them just as much authority -- but in a way that promotes trust, not intimidation. Keep in mind, of course, that improvement is each individual's own responsibility. You can only make yourself better. The best you can do for others is to develop a trusting relationship where they can ask for feedback and help when they see the need and feel sufficiently valued to take it. Getting rid of the performance review is a necessary, and affirming, step in that direction. —Dr. Culbert is a consultant, author and professor of management at the UCLA School of Management in Los Angeles. He can be reached at <http://online.wsj.com/article_email/SB122426318874844933-lMyQjAxMTIxMjE0NDIxNjQ\ zWj.html#> reports@...<http://online.wsj.com/article_email/SB122426318874844933-lMyQjAx\ MTIxMjE0NDIxNjQzWj.html/mailto:reportswsj> ..Printed in The Wall Street Journal, page R4 via online.wsj.com<http://online.wsj.com/article_email/SB122426318874844933-lMyQjAxM\ TIxMjE0NDIxNjQzWj.html> [image: Posterous] <http://posterous.com> Want your own?<http://posterous.com> Change your email settings<http://posterous.com/email_subscriptions/hash/gspsqucxgqviGogjvCufJwAxB\ xkgmH> Quote Link to comment Share on other sites More sharing options...
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