Skot:
This is an interview that was a little bit unexpected for me. I didn't know what to expect, but my interview with Manoj Prasad was very, very interesting. This guy goes into hospital systems and turns them around, sometimes not three years, sometimes like six to eight days. He goes in and has to turn on all these deficiencies that are happening. Medicaid comes into these hospital systems and says, "You're deficient in these areas." And then they say, "We need some help. Manoj, can you come help us?" Manoj says, "Yeah, I'm on my way." And he does it. That is confidence. That his competence in that area and he has gotten so good now that he turns these systems around.
He comes in and then he leaves. He just comes in to help with this specific problem. How does he do it? We're going to find out in this interview. It's really, really insightful. It is perfect for the things that I want to teach my clients as well, as far as company culture and communication, as far as brand strategy and understanding how to communicate effectively with other people around you, and how to help things turn around. This is it. Great secrets in here. Awesome gold. Let's go.
Physician, right? So you found your niche in healthcare. Now, you say, "Hey, there's hospitals that are having problems. Wait, I can help these guys. Not only because I'm a physician, I can relate to them, but also because I'm a technology expert. I get the tech side of things." Give me a little bit of background on what you do and how you do it.
Manoj Prasad:
Absolutely. In fact, one thing I found consistently over the years is that almost all organizations that I've been invited into have the same kind of issues, and that is of not being aligned to the mission of the organization. That's not for anybody's fault. Nobody's doing it with malice. It's just that they all speak different languages. Physicians have been trained a certain way, so they speak a certain language in their minds. You can tell them the best things about business. They're not accustomed to processing it as such. Similarly, the nurses have a certain kind of training. You need to be able to speak that language. Similarly, technologists are people in the labs, people in radiology, all of them have different languages. I've been fortunate that I've been exposed to all of that, and I'm able to align them together. Once they have that aha moment and they all understand that they're all working towards the same goal, accepting they were not aligned, we see magic.
SKOT:
Yeah. I've seen a lot of that too in my business, is that when I go to organizations as a brand strategist, brand is all about alignment. The three top principles of brand is differentiation, alignment, and consistency. Once you have those pieces in there, the organization rolls, right?
MANOJ PRASAD:
Exactly.
SKOT:
Now, how does that impact ... When you come into an organization, you're like, "Oh, there's some alignment issues here." And I hear they have a nickname for you. What's that nickname?
MANOJ PRASAD:
Jack of all trades, master of none or the master alignment expert.
SKOT:
Master alignment expert. Yes, yes, yes, that. The fact that you can go in and align these organizations, so they have alignment issues and it's because people talk the different languages not only professionally, but also personality-wise. We think differently. Doctors think differently. Nurses think differently. Admin thinks differently. And when you think about those and what needs to be aligned, it's really important. Taking all those things together, alignment issues that need to happen, what do you start with? When you go in, these hospitals may hire you as the temporary CEO to come in and turn things around. What do you start with?
MANOJ PRASAD:
Typically, when I go into an organization, excepting for a very few, most of them are in trouble either in financial jeopardy or they have a major issues with all their different kinds of situation where they are not completely in sync with what the regulations are. Regulatory compliance is a huge thing. Typically, when I go in, Medicare has been there, giving them a warning that we'll shut you down in 23 days unless you do this. I literally have to go in and make that quick turnaround initially, and that actually helps in a way because when the employees and other team members see you coming in with your sleeves rolled up and starting to move, they start to align around you a little bit. But where I literally have to start is in almost every case, I see the physicians who basically drive a lot of the hospital business have totally been treated as a commodity or for whatever reasons, they are not pulling together with the organization.
I start off with meeting with them. If there are trade unions, that is another one that I have to meet right off because by the time I have to be called in, they usually, their feathers have been ruffled and they are not cooperating with the organization as well. Almost in the first week itself, I start having open houses, inviting all the employees who would have some time to come and talk and meet so we can start picking their brains and talking to them about and listening to them mostly, but understanding exactly where they are coming from. It's like for the first week or 10 days, I think I'm pretty much working 20 to 22 hours into the facility to cover the three shifts. And we literally have to ... I mean, I get baptized by fire over and over again.
SKOT:
I bet you do. I can't imagine, 23 days. We're not talking, "Hey, you've got three years to turn this ship around."
MANOJ PRASAD:
Nope.
SKOT:
23 days, that's crazy. That's a lot of stress.
MANOJ PRASAD:
In three different instances I've gone in, Medicare has been there a number of times giving the hospital a chance to right the ship. I typically get called in when they leave the 200 page deficiency report with 23 days to turn it around or be suspended. So yeah, that's typically how I get baptized.
SKOT:
Wow. That's insane. And it takes a special person to be able to take on that job, right? That's a lot of confidence and competence on your side to enable that, to get that done. So what I heard you say is there are people in the organization, doctors for instance, that are treated as commodities. What does that mean? When you say they're treated as commodities, what does that mean?
MANOJ PRASAD:
Actually, everybody starts taking, mostly the management and the nursing staff and other staff start taking them for granted. They don't get the respect that they deserve. I'll tell you a simple thing. And again, it might be more of a cultural thing, but I pick up on it very early on. A lot of these guys are treated just like a distant friend, "Hey, you have to do this. You got to do this," not realizing that, hey, they are involved in taking care of somebody's life and they need support. It's a lot of manipulation goes around at, "Okay, I'm going to take this away from you. I'm not going to give this to you," not fully realizing the gravity of what they're saying.
Similarly, a lot of nurses who've been there for a while, they get taken for granted. Hey, they're going to be here no matter what. They get mistreated. Nobody listens to them, same thing with other valuable staff. They all become commodities in the hands of a few people who actually have administrative control of the organization. So that's one of the first things I have to correct saying, "Hey, let's listen to everybody with the respect that they all deserve. That's the only way we're going to bring everybody together.
SKOT:
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We put a stat out there that 82% of people feel undervalued, misunderstood, not appreciated. That's based on science, that we can understand that, "Hey, there's almost three fourths of an organization that we're not listening to." And that is what I heard was the first thing you did. So people feel like a commodity. They don't feel appreciated. They feel undervalued and they don't feel like they have a voice. Management is just like, "Hey, you just go do your job. Bill, get your patients. Crank them through so that we can get our revenues. And we don't really care what you have to say. Just do your job." But what you do first is listen, right?
MANOJ PRASAD:
Mm-hmm (affirmative). Yes.
SKOT:
Listen first, then take into account everything that you've heard and then evaluate.
MANOJ PRASAD:
Got it.
SKOT:
What's the next step? You've listened. What's the next process? What do you at that point?
MANOJ PRASAD:
Right on the first day itself, I start handing out my cellphone, personal cellphone numbers to everyone, with an invitation for them to call me 24/7. And by the way, trust me, they do. Typically, they want to test you, saying how genuine are you. They'll call you at two in the morning with a problem. Luckily, I have the habit of being able to get on the phone in the middle of the night, talk to them, fall asleep, and also remember what I said the next day. I will do that. I'll go and sit in there. The one thing that I've learned very early on is that I never asked anybody to come and meet me in my office. Because even to the most trained and senior person, being called to the CEO's office is like being called to the principal's office.
I will go to their offices. I sit in the nurses' station and talk to the nurses. I sit in the radiology to talk to them or the labs. That's how I build rapport and they understand that this guy understands what we are saying and at least is listening to us. The next thing I do is I've got a little bag of tricks, I call them. I initiate literally a true open door. People can literally walk into the CEO's office. If I'm not in a meeting, they can actually talk to me or they can just call me. I am responsive. I don't let my inbox sit ... I mean, I empty it every day. Then I start doing things to appreciate people. Once the actual fire is put out, I start doing things for appreciation.
It might be things like in a multilevel hospital, how do I get the nurses to put in that extra effort for the patients? I start off a competition. I call it lunch with the bunch, for example. Each floor, I usually use Press Ganey or something to measure patient satisfaction that's broken down every month. And each month, whoever's the winner of different floors, I take that entire staff out to a steak dinner and appreciate them for what they do and literally ask them, "How did you do this?" Now, pretty soon you start getting everybody involved because it's a group effort. The entire group gets engaged in doing this. And then they start telling the physicians, "Hey, when you leave the room, ask if they want the doors shut or what have you." I start doing that. Then the second thing is when I round the entire facility myself without a whole bunch of folks. I just do it myself. I talk to patients and ask them how they've been treated.
And anybody who stands out, I do that whole thing. Next morning, a gift certificate, balloons, and the works. I grab their manager and we go to the patient right on the floor and appreciate them. This kind of stuff actually starts taking on. Everybody starts wanting to be there and other kinds of competitive things where end result is everybody's working towards providing better care. That actually pays off in a big way. It also pays off financially. Because for example, I'll tell you in a hospital, the biggest mistake most facilities make is, and that's why they lose a lot of money, is they hired the least qualified or educated person in the front office as the registration person who's not vested in getting everything right. So all the hard work that the people do in the backend, the billing is wrong because they got the wrong information. So I create vertical teams where the front end, everybody is together, and these teams, whoever does the best every month, they get rewarded. How are we going to get a whole bunch of these kinds of things which makes a tremendous difference?
SKOT:
This is awesome because what I hear you saying is that it takes investment in people.
MANOJ PRASAD:
Yes.
SKOT:
We're so concerned with the bottom line, right? So you have healthcare executives that may be out there that are just like, "Production, production, production, billables, billables," right?
MANOJ PRASAD:
Uh-huh (affirmative).
SKOT:
"Get that money in," whatever it is. What your approach, I haven't heard you talk about any of that. I'm sure there's a technology side to what you do. I know that there is.
MANOJ PRASAD:
Yeah.
SKOT:
But that's not at the forefront of what you do. You go in, you listen, you ingrain yourself in the culture. And what it is that I hear you doing is build trust. Everything that I've heard you do talks about building trust.
MANOJ PRASAD:
Exactly.
SKOT:
Test me at 2:00 AM, right?
MANOJ PRASAD:
Yeah.
SKOT:
Let's put a competition out there and I will reward you. Let's talk to the patients. Let's sit down in your station. I don't want you to come to my office. You don't have to come to my office. I'll come to you, right?
MANOJ PRASAD:
Yeah.
SKOT:
I want you to trust me. Know I'm here for you to build you up and to make us all successful.
MANOJ PRASAD:
Exactly.
SKOT:
And that is what's so important. I measure company culture with five different metrics. It's communication, relationship, alignment, and then execution, and capacity. Those are the five things I do. A lot of executives just go alignment, execution. Get on the same page and get it done, alignment, execution. But before alignment can happen, which is what you are the king of, you built communication or relationships, a foundation in order to build consistent alignment, in order for us to execute and increase capacity. Am I right?
MANOJ PRASAD:
Absolutely. And then somewhere in there, one of the things that I've seen unfortunately in too many hospitals is they'll suddenly, they're not performing well, they'll call in a Lean practitioner or they'll call in somebody else. They initiate a program and the entire staff's eyes glaze over saying, "Oh my God, another Six Sigma, another initiative." And nobody does anything about it.
What I do is I silently, I don't mention the name Lean. I mean, I'm certified in all of these. I push in Kaizens very softly. So instead of calling it Kaizens or theory of constraints, I will get groups together and say, "Hey, why don't we look at this? And the groups that can do this, I'll recognize you and reward you." Now suddenly, the entire facility is actually doing a Six Sigma project without an understanding that they are doing it or a Lean project. And then some of them who are actually outliers, suddenly one day will say, "You're doing a Kaizen aren't you?" And then I have to admit, "Yeah, that's what I was trying to do." But everybody gets into it and gets behind it, so it becomes fun to come to work and not a burden.
SKOT:
Oh, it's so good. You're rewarding, not punishing, right?
MANOJ PRASAD:
Exactly.
SKOT:
We do this with our kids all the time, right?
MANOJ PRASAD:
Yeah.
SKOT:
We candy coat things to make it more palatable, right?
MANOJ PRASAD:
True.
SKOT:
For them to eat certain foods, but because we know it's good for them. We know that they'll get something out of it and maybe they'll like it. And so, teach me about this phrase. We've heard it a lot, but teaching man to fish. Because you don't stay at these places forever. They hire you for a period and you can tell us how long that period is, but you talk about teaching someone to fish. Tell me about that philosophy with you.
MANOJ PRASAD:
Sure. Actually, initially, it used to take me a year and a half to turn around and then another year to stabilize and keep running it. Now, I perfected it so that in a year's time, I can do a turnaround and stabilization. Because I've always lived here in Michigan and traveled everywhere, I've done international projects also from Michigan. I like to limit my travel as much as I can after a while. It gets old. But generally, like for example when I'm called into a troubled organization, maybe going through a bankruptcy or something, I have been called and I have actually in the past arranged for funding for them as well. But just providing funding to them, like providing fish to them, it's not going to solve a problem because the inherent system problems will remain.
So what I do is in all my 30 years that I've been doing this, I have only let one person go by the way. And that was because of some criminal activities that I found out about. But other than that, I never let people go. I work with the people who are there and I teach them how to become very good at their tasks, support them with education, provide them the training that I do. I'm also an educator so I am able to teach them a lot of things. I'll give you a funny example. In one place, I had this HR director who was the biggest gossip in town, and how that goes with HR. She would be in everybody's business. Instead of letting her go, I caught her a couple of times letting confidences out, so all I did was I reassigned her to head the housekeeping and facilities management area. She was so good at it because she was in everybody's business making sure this is clean, that is there. She became absolutely a runaway success.
SKOT:
That's great.
MANOJ PRASAD:
She was in the wrong spot for that. That's how I work with a lot of people who are there. The other thing that I typically run across is by the time I'm called in, most of the good people who are employable have already left so it's a lot of people who are not very employable or disheartened who are there. It's absolutely a pleasure to see them light up and become ... They're all potentially very good people. Otherwise, they would not be in the industry. So to help them get absolutely fabulous at it ... I'll give another short example. One facility that was actually 12 days away from being shut down, because Medicare had been there so many times and each time they would leave and it would be a ton and ton of deficiencies. After I got done, people would come for surprise visits.
It was so much fun to see that after a couple of visits, nobody even paid attention to them because it was now part of the culture to do things right. If Medicare showed up for a surprise visit, they won't even bat an eyelid. In the past, it used to be panic city saying, "Hey, we'll be shut down today or tomorrow." That's how you see the transformation, so it's such a pleasure actually seeing this transformation. And that's how I teach them how to fish and excel at what they do.
SKOT:
That's great because then, people enjoy coming to work. They're not fearful and they let down their walls. They're more open. They leave work happier. Their home lives are better. I always talk about your brand being your reputation, what other people say about you when you're not around, a lot of people talk about brand from an external standpoint, from the marketing standpoint.
I talk about it as an internal brand strategist from the inside. What are your employees, what are your staff, what are your leaders saying about you when they go home at night? And if I am constantly living in fear at my job, if I am nervous about my job, if I see a new interim CEO coming in and just cleaning house, letting 50% of the staff go, that instills fear. And what does that do for the culture? It's so smart of you to take the people that are there because they know more than you do about what's going on, right?
MANOJ PRASAD:
Exactly. Yep.
SKOT:
And invest in them. They're there maybe, like you said, it could be a fantastic person in the wrong seat. Let's find out where they do work. This is gold. I hope that people are listening to this because yes, this applies to hospital systems. But hold on, this is for everybody. Yeah. This is for everything and I hope that people are really grasping onto that. This has been fantastic. I've loved talking to you. I had no idea that this was going to happen in this interview.
MANOJ PRASAD:
My pleasure.
SKOT:
I really appreciate it. Where can people find out more about you or get in touch with you if they need help or if they would just like to hear you speak or pick your brain, what can they do? How can they contact you?
MANOJ PRASAD:
They can either email me or they can call me. I'm married to my cellphone. I never move away from it. So if you wanted to put up my number, I'm more than happy to share. Should I just read it out?
SKOT:
Oh, sure. If you're open to that, I think that that's fantastic. Yeah.
MANOJ PRASAD:
Absolutely. (313) 405-5945. That's my cell number. And my email is also very simple. It is ceoxc, so it's a CEO like a chief executive officer, XC which stands for Xpertease Consultants, it's my company, @outlook.com. Reach out to me. I'd be delighted to assist in any way anybody wishes.
SKOT:
That's fantastic. I don't think I'm going to have many people that are going to give out their cellphone number over this interview process. But can I call you at 2:00 AM?
MANOJ PRASAD:
Absolutely. I can still wake up, talk to you, make some sense, and then fall asleep and remember it the next morning. That's the trick.
SKOT:
That's brilliant. I love it. I love it. Manoj, this has been fantastic. I appreciate your time and sharing your knowledge with all the listeners. I hope they learned something from this. I know I did. I appreciate you.
What? Yeah. Right? Alignment, aligning people builds trust. He goes into a hospital system that is in default, that is having some troubles and he talks to the people. He doesn't start just like get rid of everybody. He invests in the people that are there, helps them feel valued, heard, understood, aligns them to what the core mission is of that specific department or the entire business as a whole and gets agreement and understands what to do to move forward. He works on building trust and that trust comes because of aligning systems and people and goals and the vision of what needs to happen next.
I hope you got a lot out of this. This was really, really good stuff. I hope to see you next time. Again, visit my YouTube channel. You can subscribe there and there's going to be plenty of interviews there of insightful information for you. You can also visit my website at skotwaldron.com. And again, this is brought to you by Giant. Remember, you can get a free subscription to Giant, free if you use the term or type in the URL giant.tv/30days. All right, I will see you on the next interview. Have fun, y'all.
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