BBHP: The high cost of bad behavior

Everybody experiences far more than he understands. Yet it is experience, rather than understanding, that influences behavior. Tell a FriendMarshall McLuhan

I am indebted to many colleagues in the related health care professions for introducing me to the Badly Behaving High Performer (BBHP). These are those individuals in every organization that are given significant latitude for recurrent bad behavior because they add significant sums to the bottom line. Some might infer that this phrase is reserved for physicians.  To the contrary, no profession, career or organization is immune from this phenomenon.  Nurses speak of their profession as one in which they “eat their young”.  Over 30 years of practicing law has introduced me to a few BBHP’s with law licenses. Anyone to whom the rules don’t apply may be a BBHP.

We have less difficulty dealing with badly behaving poor performers.  Organizations quickly respond to bad behavior that leads to bad performance.  Discipline, performance improvement plans and ultimately termination are visited on BBPP’s routinely.

High performers are another story altogether.  Today’s New York Times provides interesting insights concerning the impact organizations suffer when they endorse, tolerate or even reward the behavior of high performing louts.  Immediate demoralization, reduced productivity and turnover of valued employees are some of the more obvious costs incurred by employers and organizations unprepared to deal with the BBHP.  Research establishes that turnover attributed to the bad behaving peer, subordinate or superior is rarely reported.  Ample evidence exists to establish that employees do not leave employers, they leave their supervisor, manager or colleague who lacks common civility.  In health care, a single nurse turnover attributed to “lateral violence” by their colleagues, superiors or other unaddressed BBHP can cost in excess of $70,000 to recruit, train, retain and replace.  Of course not all nurses leave their jobs due to BBHP, but many do.

Evidence also exists to establish that a significantly disproportionate number of medical malpractice claims are attributed to physician behavior that is not professionally incompetent, but merely impolite, arrogant or uncivil.  Dr. Jerry Hickson at Vanderbilt University Medical Center has amassed significant data to support the premise that the vast majority of medical malpractice claims are due to physician bad behavior on the part of a very distinct minority of physicians.  The Joint Commission issued a sentinel event alert in 2008 which requires all recipients of Medicare dollars to develop programs, create policies and train all employees, managers and supervisors in the elimination of “disruptive behavior.”

Professors Pearson and Porath have conducted studies of over 9000 employees in workplaces across the nation.  The data reported in their book is stunning, but not surprising:

“60 percent of disrespectful behavior came from above, 20 percent from colleagues on the same level and 20 percent from below. And half said they decreased their effort on the job after experiencing ongoing rude behavior. Professor Pearson said that could mean that the workers did not put in the extra effort they otherwise might have, or that they worked strictly to their job description, or even that they slacked off.”

The lack of initiative to perform discretionary tasks in the workplace, is one of the greatest drains on productivity, profitability and employee intrinsic motivation. It demoralizes others and “begets more of the same”.

Might it be that violence and bullying in schools is patterned after incivility being witnessed by our children in the workplace, the grocery store, parking lots and homes?

We can change these trends if we care to.  We need to be willing to learn how to confront bad behavior at the source and in real time.  Tolerating it only rewards it and insures more of it.

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