Life Lesson

Planning For A Healthy New Year? READ those labels!

Approaching the New Year in just 6 weeks, this is the time many set healthy habit goals to prepare for the coming year. Often this includes exercise either at the gym, home or outdoors and better eating habits along with purchasing vitamins and supplements. Before you head out to fill your cabinet with bottles of tablets and packets, here are some facts you should know.

“Dietary Supplements can be beneficial to your health — but taking supplements can also involve health risks. The U.S. Food and Drug Administration (FDA) does not have the authority to review dietary supplement products for safety and effectiveness before they are marketed.” Food and Drug Administration

Vitamins and supplements can pose a danger and be toxic. PLEASE refer to your physician or a licensed certified nutritionist before taking any vitamins and supplements. The reason your friends, family members, coworkers and acquaintances might be taking certain supplements should not be your reason. If someone is trying to convince you to take or buy a supplement pack and discourages you from talking with your physician or nutritionist, this is a great reason to say NO, THANK YOU. Especially, be very careful taking supplement products that promote weight loss or are used to build muscle. A recent article in the Wall Street Journal, New Evidence for Critics of Weight-Loss and Sport Supplements warns about liver damage and states…

“Dietary supplements make lots of claims and consumers often believe them: The booming U.S. industry has grown from $9 billion in sales in 2007 to $15 billion this year, according to Euromonitor International, a market research firm. But a new study gives ammunition to critics of the supplements and their potential health risks. The study found two banned stimulants and two previously unknown and little-studied substances in six weight-loss and sports supplementssold in the U.S. The researchers defined “banned” as “ingredients for which the U.S. Food and Drug Administration had taken enforcement action to remove from dietary supplements prior to August 2016 (when the samples were purchased).”

Often, the vitamins you are already getting through food may be providing the essential vitamins you need. “But the combination of whole foods, supplements, and fortified foods raises safety concerns with experts. Eating fortified foods while also taking supplements can cause a person’s diet to exceed safe upper levels and potentially lead to a toxic buildup.” Webmd Only a physician and/or licensed certified nutritionist, often through the results of blood tests, can accurately discern what vitamins and minerals you might be lacking. Also, some supplements already contain vitamins other than the primary name listed on the label. It is very important you read the ingredient labels and small print before adding to your daily intake, to avoid duplicity. Here are a few examples.

I was taking ZINC as a supplement tablet. Then I started taking Ocuvite for eye health. I realized after reading the ingredient label, Ocuvite already has 40 mg of Zinc. I was exceeding Zinc daily recommendations and didn’t realize this for a few weeks. WebMD indicates the side effects of Zinc here.

Another situation came up where an individual I know began taking an IRON AID daily tablet. Within a week symptoms of delirium, rash, stomach issues suddenly came about. After reviewing all medications including supplements, discovered the IRON AID included 400 mcg of Folic Acid, which is not good when already taking a daily Folic Acid supplement of 1000 mcg. Toxic level of Folic Acid is noted at 1200 mcg daily and this individual was consuming 1400 mcg daily. Once taken off Folic Acid all symptoms disappeared within a week. Click here about Folic Acid and its side effects.

Below is a listing of common vitamins and toxic side effects possible (taken from the noted hyperlinked “article here” resources) when exceeding the recommended maximum amounts. New findings also suggest that the body doesn’t always flush out the excess of water-soluble vitamins. Therefore, even water-soluble vitamins pose a toxic risk when exceeding recommended amounts. In addition to these risks, taking vitamins/supplements may interfere with prescription medicine including over-the-counter blood thinners.

Almost 60,000 instances of vitamin toxicity are reported annually to US poison control centers. According to National Health and Nutrition Examination Survey (NHANES) data, in 2003–2006 33% of the United States population aged 1 year and older took a multivitamin supplement in a given month.  In a 2009 survey, 56% of US consumers said they take vitamins or supplements, with 44% saying they take them daily.   Vitamin Toxicity, December 21, 2016

Vitamin A – “Acute symptoms drowsiness – irritability, abdominal pain, nausea, vomiting, increased brain pressure. Chronic – blurry vision & changes, swelling and pain of bones, poor appetite, dizziness, nausea and vomiting, sensitivity to sunlight, dry rough skin, itchy peeling skin, cracked finger nails, cracked skin around mouth, mouth ulcers, yellow skin, hair loss, respiratory infection, confusion.” Article here.

Vitamin B Family

B1 – “Blue colored lips, chest pain, feeling short of breath; black, bloody, or tarry stools, or coughing up blood or vomit that looks like coffee grounds, nausea, tight feeling in your throat, sweating, feeling warm, mild rash or itching, feeling restless, or tenderness or a hard lump where a thiamine injection was given.” Article here.

B2 – “Sun-induced eye damage, itching or numbing sensations, and orange-tinted urine.” Article here.

B6 – “Nerve damage, decreased sensation to touch, temperature, and vibration, loss of balance or coordination, numbness in your feet or around your mouth, clumsiness in your hands, or feeling tired, nausea, headache, drowsiness, mild numbness or tinkling.” Article here. 

B12 – “Restenosis (reoccurrence of narrowing of a blood vessel) after stent placement, high blood pressure, acne, rash, itchy or burning skin, pink or red skin discoloration, facial flushing, urine discoloration, numbness, nausea, difficulty swallowing, diarrhea, increase in blood volume and red blood cells, low potassium levels, gout flare-up.”    Article here.

Vitamin C – “Diarrhea nausea vomiting heartburn abdominal bloating and cramps headache insomnia kidney stones.” Article here.

Vitamin D – “Buildup of calcium in your blood (hypercalcemia), which can cause poor appetite, nausea and vomiting. Weakness, frequent urination and kidney problems also may occur.” Article here.

Vitamin E – “If you have a condition such as heart disease or diabetes, do not take doses of 400 IU/day or more. Some research suggests that high doses might increase the chance of death and possibly cause other serious side effects. The higher the dose, the greater the risk of serious side effects. There is some concern that vitamin E might increase the chance of having a serious stroke called hemorrhagic stroke, which is bleeding into the brain. Some research shows that taking vitamin E in doses of 300-800 IU each day might increase the chance of this kind of stroke by 22%. However, in contrast, vitamin E might decrease the chance of having a less severe stroke called an ischemic stroke.” Article here.

Iron – “Symptoms of an iron overdose include nausea, diarrhea, black stools, vomiting blood, a metallic taste in your mouth, stomach pain, fever and headache, which sometimes but not always occur within an hour of taking too many iron supplements. If you don’t get treatment, more severe overdose symptoms may include dizziness, chills, drowsiness, and pale or flushed skin, fast or weak pulse and low blood pressure.” Article here. 

Folic Acid – “Less serious side effects include digestive problems, nausea, loss of appetite, bloating, gas, a bitter or unpleasant taste in the mouth, sleep disturbances, depression, excessive excitement, irritability and a zinc deficiency. More severe signs include psychotic behavior, numbness or tingling, mouth pain, weakness, trouble concentrating, confusion, fatigue and even seizures. An allergic reaction to folic acid may cause wheezing, swelling of the face and throat or a skin rash.” Article here.

Magnesium – “Doses less than 350 mg daily are safe for most adults. When taken in very large amounts, magnesium is POSSIBLY UNSAFE. Large doses might cause too much magnesium to build up in the body, causing serious side effects including an irregular heartbeat, low blood pressure, confusion, slowed breathing, coma, and death.” Article here. 

Do older and inactive individuals require less vitamins? Well, this is not actually the case. As we grow older we tend to consume less calories, which means less food and therefore less vitamins from the foods we eat. This would indicate vitamin supplements may be needed. This article explains…Nutrition Over 70; A guide to Senior Dietary Needs. Published findings and talking with friends and family, however, ARE NOT to replace conversations about vitamins and supplements with a physician or their referral to a licensed and certified nutritionist.

There are no health risks when the body absorbs vitamins through a balanced diet of whole and natural foods. There is, however, a greater risk of toxicity from vitamins through dietary supplements and fortified foods. Best way to plan for the New Year…make an appointment with your General Practitioner, if you haven’t already. Discuss your physical fitness goals and review your everyday eating habits along with vitamin and supplement needs. AND, READ THOSE LABELS! Just because a bottle labels a certain vitamin doesn’t mean it doesn’t also contain other vitamins. Duplicity of vitamins can be toxic!

Additional Resources

What are the Most Toxic Vitamins? by LAURA KENNY

Life Lesson

Color Your Communications!

 

A number of years ago I began managing my mother’s medical care. When I moved out-of-state in 2014, online communications with medical staff was an easy solution for healthcare management. Processing and managing prescriptions and vitamin supplements – far more challenging.  This published post shares a simple idea for managing prescriptions if you live miles away or in another state, yet continue to maintain responsibility for assisting parents, extended family members, or friends.

Whenever possible, the first suggestion is to participate in prescription mail order. This allows the patient (in many cases) to get a 90 day supply of ongoing prescriptions compared to a 30 day supply. Less ordering simplifies prescription management. Second, have a plan in place to monitor prescriptions running low as the care receiver may not always tell you prior to a dwindled down supply. This could include calendaring when to reorder and/or asking if the prescription/vitamin supplement is running low. Problems come into play when elderly vision is poor (even with glasses), which makes reading small print on glossy labels very difficult. If the care receiver has been diagnosed with low vision impairment, reading prescription and supplement labels is impossible. Often times my mom would call and request a refill but couldn’t read the name of the medication on the bottle. Asking for a reorder of the “large white pills” doesn’t suffice when most all the pills are white and size is subjective. This dilemma has led to color coding prescription and vitamin supplement bottles with stickers, using different shapes to accomodate many bottles.

Instructions for Color Coding

  1. Inventory prescriptions and supplements to determine quantity of bottles that require color coding.
  2. Purchase stickers, making sure the colors are distinguishable for the care receiver. Example – using both light pink and standard pink might be difficult to discern. Purchase different shape stickers, such as dots and stars, if working with many bottles. Although not shown in the blog photo, all prescriptions could be stars and the supplements could have color dots or vice-versa.
  3. It’s CRITICAL to place the color stickers on the BOTTOM of bottles because most bottle caps are universal. A serious problem could ensue if the wrong color coded cap got on prescription bottle.
  4. Create a color coded chart and be sure one copy is at the home of the care receiver. Keep a hard copy at your home for quick reference and distribute to others who might need this information, perhaps emailing as an attachment for recipients to save as a computer copy. This hyperlinked PDF, Prescriptions and Vitamins w.RX# – color coded,is an example of such a chart. Place the chart so it is visible in the care receivers home, serving a dual purpose to provide vital information in the event paramedics are called, for their quick emergency care response.

Refill Solution 

When medication or supplements are running low the care receiver simply calls you (texts or emails) and requests, “reorder the orange label” or “reorder the blue star”. When refill bottles arrive, if the care receiver is not able or you don’t reside locally to place color stickers on the bottles, have someone you trust do this for you. When visiting the care receiver it is always a good idea to check all medications and supplements to be sure the color stickers align with the color chart.

Managing healthcare for aging parents, family members, or friends has its challenges, especially when living at a distance. Workable and safe solutions can make life easier on everyone. Color your communications and see how this effective and efficient solution modifies your ability to be a dependable and trusting caregiver to those you love.

Resources

Amazon.com color stickers available:

 

Life Lesson

Patient Beware UPDATE!

Pataient Beware UPDATE _edited-1

This article is an update to the published blog, Patient Beware, posted on May 11, 2017 explaining the Medicare issues that arise when a patient is admitted to the hospital “under observation”.

“While under observation, patients can be liable for substantial hospital bills, and Medicare will not pay for subsequent nursing home care unless a person has spent three consecutive days in the hospital as an inpatient.” New Medicare Law to Notify Patients of Loophole in Nursing Home Coverage

A new law came into affect this past March 2017, which requires WRITTEN notice by hospitals to patients admitted under observation for more than 24 hours.Medicare Outpatient Observation Notice (MOON)

“The new notice drafted by Medicare officials must be provided after the patient has received observation care for 24 hours and no later than 36 hours. Although there’s a space for patients or their representatives to sign it “to show you received and understand this notice,” the instructions for providers say signing is optional. By law, hospitals now must tell Medicare patients when care is ‘observation’ only – March 9, 2017.

The hyperlinked article above does a great job explaining the law and patient rights.

At the time a patient is admitted to a room, the patient and family member advocates have a right to know status; inpatient or observation and why. As noted above, written notice is legally required if the patient receives observation services beyond 24 hours.

A recent experience prompted this post writing because of confusion around whom to ask about admittance status and the appropriate words to use when asking. This is a true story. Patient identity is being protected.

After this law had been in affect for 5 months, an individual was hospitalized and admitted to the ER for chest pains in August 2017. Given a thorough check along with a number of tests, the ER doctor determined this person should be admitted. After assigned a room, a family member spoke with the attending nurse and asked, “Is admittance inpatient or under observation?” The nurse replied, inpatient. The question was asked again, to be certain, and the attending nurse this time replied, “I assure you, this patient has been admitted and given this room as an inpatient and not under observation.”

The following day the patient was discharged and the Patient Care Coordinator (PCC) requested papers to be signed. These papers noted, “admitted under observation”, and the patient could be liable for additional fees for medical exams, tests, x-rays, medications, etc., that may not be covered under Medicare because of observation status. The PCC could not disclose the $$$ amount of additional fees, if any, and stated that patient services received would be reviewed and fees determined by the hospital’s accounting department. Here is the problem. The attending nurse assured patient and family the prior day about inpatient status. Now patient and family member are preparing for discharge under observation and without knowledge of costs incurred. Unsettling for sure!

The family member questioned the PCC about this misunderstanding; however, the coordinator makes it clear that admittance according to hospital records was not “inpatient”. The PCC asks, “Did the nurse use the word patient or inpatient, because only the word inpatient refers to hospital admittance. Just saying patient refers to observation status.” When a family member is in the hospital with angst running high and nerves frayed, have we really come to that point of having to wordsmith conversations with hospital staff?? It appears so!

The PCC then states to the family member that the attending nurse was not the right person to ask about admittance status. The family member should have spoken with the doctor or the PCC and not nursing staff. Below are my two responses to this statement:

  1. If someone on staff assures you of admittance status, especially the attending nurse, what reason would you have to seek an answer from anyone else?
  2. It IS the responsibility of hospital management to advise/train employees to discern questions they can answer and questions that must be referred to appropriate hospital staff. This is NOT the responsibility of the patient and/or their family members.

Even though a law is in affect regarding required communication protocol when patients are admitted to the hospital, this doesn’t mean it will be followed. Patient and family members, therefore, need to be vigilant.

What you need to know

New Medicare Law to Notify Patients of Loophole in Nursing Home Coverage discusses the legal requirement that patients be given verbal notification about their observation status followed by written notice using the Medicare form MOON if the patient is receiving such services exceeding 24 hours. MOON requires all hospitals (as of March 8, 2017) to also explain WHY the patient is receiving care under observation and not as inpatient, along with charges Medicare may not cover once the patient is discharged. The form is available in English – CMS-10611 MOON_v508 and SPANISH – CMS-10611 MOON Spanish_LARGEPRINTv508 . Also see MOON-FAQs, an informative document for review.

Anytime you (or a family member) are sent to the ER and referred to a hospital room, ask the hospital doctor or PCC about admittance status. Any other hospital staff may not be authorized or able to provide accurate information.

If you/family member are being held under observation, also ask those authorized; length of anticipated hospital stay, specifically why observation and not inpatient and additional costs, if any, that Medicare (or medical insurance) won’t cover. Even through the Moon Form is not required until observation status exceeds 24 hours, the patient has the right to know this information verbally at the time a hospital room is assigned.

“When patients are too sick to go home but not sick enough to be admitted, observation care gives doctors time to figure out what’s wrong. It is considered an outpatient service, like a doctor’s visit. Unless their care falls under a new Medicare bundled-payment category, observation patients pay a share of the cost of each test, treatment or other services.” By law, hospitals now must tell Medicare patients when care is ‘observation’ only – March 9, 2017. 

If already diagnosed at the ER, it would appear observation is not necessary. So, why wouldn’t the patient be admitted as an inpatient? Typically, only a doctor can explain this and request inpatient status for the patient. Speak to your doctor, especially if diagnosed at the ER with an anticipated stay greater than 24 hours. It appears patients most vulnerable to HUGE out of pocket expenses are those admitted under observation who require nursing rehab care when discharged. If you are hospitalized, suggest having a family member or trusted friend with you when asking these questions and signing any paperwork.

How did it end for the patient whose story is shared above? Discharged by the 24 hour mark. Did not require nursing home, rehab or assisted living services. The family member signed the discharge papers noting next to the signature, that the patient and family member were assured inpatient admittance, therefore, additional fees or charges, if any, resulting from observation status are not to be the patient’s responsibility. Thankfully, no additional fees were invoiced to the patient.

We don’t know what we don’t know until we experience it first hand or through the experience of others. The purpose of this blog is to SHARE information, especially on important issues that can negatively impact someone’s life. Be prepared and know about patient’s rights whether coverage is through Medicare or individual health care plans. What you learn now will save you time and money later, especially when spending quality patient time with family is your top priority. Let’s all be informed and share these posts with those you know – Patient Beware and Patient Beware Update.

Resources

  1. Medicare Outpatient Observation Notice (MOON)
  2. New Medicare Law to Notify Patients of Loophole in Nursing Home Coverage
  3. New Medicare Law To Notify Nursing Home Coverage NY TIMES …
  4. Are You In The Hospital Or Not? AARP 

 

 

 

Life Lesson

Discovering Your Cultural Fit

Cultural Fit_Part 3 - edited-1_edited-3

Whether you are currently employed or a candidate job searching, it’s easy to fall into the trap of “just wanting a job and one that pays well”, as the primary goal. Making sure that the company cultural fit is a match for you, however, can be critical for your long-term career aspirations and success.

Today, companies look for skill and experience as well as how employees and candidates fit their company culture. When hiring, Cultural Fit Interview Questions by Workable.com, provides an excellent summary PDF for employers to understand cultural match. And, as this article notes, “Candidates also have a say in whether they’ll fit well with your company.” For this reason, applicants should understand the cultural fit that best meets their needs in order to thrive. Therefore, Cultural Fit Interview Questions is an effective tool for candidates, too. In addition, a list of questions are noted below for job seekers, whether currently employed and feel as if you are swimming in static waters or for those unemployed and actively interviewing; workforce veteran or college grad. After working through the lists, job seekers will hopefully come away with a good grasp about corporate culture, style and fit.

Once you have concluded the personality of the company and how they “roll”, make a decision if the company is a match for you and stick with it. Not every item on your list will be checked, so know where you are willing to make compromises. Make sure you are comfortable with your future team and your direct report is excited to have you on-board. Anything less is a red flag!

How should you respond if a job is offered and you are filled with uncertainty and you notice red flags? Bring up your concerns. How much of your concern is angst and how many apprehensions are valid, which hopefully can be worked through? Having said this, I know someone who had a number of concerns joining a company based on a level of discomfort and red flags. After discussing these concerns with a few employees, this individual was assured worries were unfounded. But, the executive director’s excitement did not appear to be authentic. The job lasted 29 days. Like a marriage, people show their best before the “ceremony” and any quirks become magnified after the honeymoon is over. Every situation is different and I share this story because the last thing anyone wants… a job that requires constantly having to look over the shoulder sensing that “something” is just not right! This then becomes a working environment not conducive to success, blocking the ability for anyone to thrive; the employee, team, department and company.

If you are employed and suddenly terminated without explanation and specifics, other than being told “not a cultural fit”, there can be an overwhelming feeling of injustice and mistreatment leading to suspicion of unlawful termination. At this point there might not be an opportunity to filter through work emails and forward accolades to your personal email. You could be immediately cutoff from the company server if working from home or escorted out of the office by security. It’s in the best interest of every employee to FORWARD emails to a personal account and SAVE all positive correspondence and performance reviews. Journaling direct report meetings and conversations is a good idea, as well. To pursue legal steps you may need all relevant documentation to prove unlawful termination.

How to identify corporate personal bias? Suspicion happens most often when the culture of a company is not documented and executive leadership can’t explain why someone is not a cultural fit, either passed up for hire or an employee is terminated suddenly. “It is an incredibly vague term and it’s a vague term often based on gut instinct,” says Wharton management professor Katherine Klein, Vice Dean of the Wharton Social Impact Initiative. “The biggest problem is that while we invoke cultural fit as a reason to hire someone, it is far more common to use it to not hire someone.  People can’t tell you what aspect of the culture they are worried about.” Is Cultural Fit a Qualification for Hiring or a Disguise for Bias? 

An employee wrongfully terminated can independently seek legal counsel or file a complaint with the U.S. Equal Employment Opportunity Commission. This would especially be necessary if you believe termination may come under any one of the federal protected classes.

Employers can and should use cultural fit as an effective means of bridging diversity with the values and beliefs needed to successfully achieve corporate vision. As an employee, the steps you take to determine cultural fit in an organization is equally your responsibility as it is the company hiring. This all becomes tricky when companies loosely wave this term around without having a documented description of “corporate culture” defined along with its connection to strategic business goals. Hopefully, by properly understanding the term cultural fit, employers and employees can reduce the risk of personal bias and discriminatory masking. Be proactive as a corporation and define your corporate culture! As a potential or existing employee, know your cultural fit!

Discover Your Cultural Fit – Questions

Describe your ideal job. What qualities do you need to flourish?

Describe the ideal company for you.  

  • Industry/field
  • Large, medium, small?
  • Start up company?
  • Company ramping up growth?
  • Well-established and structured company?
  • Specific company names? (Although these companies may not be hiring, you can use the names noted to gauge similar companies.)

Describe your successful working habits?

  • Alone and focused
  • Team player and interactive
  • Structured
  • Entrepreneurial spirit

Describe your ideal working environment?

  • Location (big city, suburban campus, or, work remotely from home)
  • Quiet and subdued
  • Busy, interactive, and not quiet
  • Offices and/or cubicles
  • Open concept with desks
  • Work remotely from home, always or part time

How does the working environment feel to you?

  • Upbeat, energetic, loud
  • Serious and quite
  • Stressful
  • People interacting or primarily working alone?
  • Open or closed office doors?
  • Do you feel like your input would be valued and respected?

Prepare For The Interview

  • Be prepared. Know in advance how you might be interviewed. Internet search and find articles describing current interview trends. Below are two articles about interviews where the term “cultural fit” is used.

Three Ways to Know if An Employee Is A Cultural Fit? By Jeff Pruitt, Chairman and CEO, Tallwave, published INC.com, How To Hire The Best,

Cultural Fit Interview Questions by Workable.com

Interview Questions To Ask The Interviewee

Describe the ideal candidate for this job?

  • Education
  • Skill
  • Experience
  • Personality
  • Works independently or part of a team?

Describe the culture of your organization?

  • Describe an employee(s) who you feel is a great cultural fit and why you feel this way?
  • If a candidate or employee is not a cultural fit, what three traits would bring you to this conclusion?

What traits or working habits do you feel would not be a good cultural fit for this position?

  • If this question cannot be answered directly and adequately in the interview process, and you notice a wide gap differential when comparing yourself and the current employees of the firm, this may not be the company for you.

“The only way that culture in the workplace is effective is if there are sets of values that help the company achieve its strategy,” Barsade notes. “When there is thoughtfulness around what the values are and you tie that to hiring, then you have best hiring practices.” Is Cultural Fit a Qualification for Hiring or a Disguise for Bias? Knowledge@Wharton, Management

Are performance reviews conducted, and if so, how often?

  • Is cultural fit a part of the job interview?

Is it possible for this job to move into other promotable positions? Or, are you looking to fill this position as a steady long-term role?

  • Is this position replacing someone who resigned or one who has been promoted?

 

Resources

Cultural Fit Interview Questions by Workable.com
Is Cultural Fit a Qualification for Hiring or a Disguise for Bias? Knowledge@Wharton, Management, July 16, 2015
Three Ways to Know if An Employee Is A Cultural Fit? By Jeff Pruitt, Chairman and CEO, Tallwave, published INC.com, How To Hire The Best, August 12, 2016
U.S. Equal Employment Opportunity Commission –  Filing a Complaint
U.S. Equal Employment Opportunity Commission – Protected Classes 
Life Lesson

The Rise of Cultural Fit and Decline of Performance Reviews – How to protect against personal bias?

Cultural Fit_Part 2 - edited-1_edited-3

Conducting research to write this post, I feel it is ironic that the rise of “cultural fit” appears to move at a similar rate to the decline of job performance reviews. This trend could make it easier to hire and terminate “at will”  based on personal bias.

At one time performance reviews were the norm, and, perhaps in some companies this method of employee evaluation still exists. An article in HBR, November 2016 issue, Let’s Not Kill Performance Evaluations Yetnotes that by the end of 2015, 30 Fortune 500 companies eliminated performance reviews. Below is a quote from this article, which defines performance and the benefit of evaluations.

“Performance is the value of employees’ contributions to the organization over time. And that value needs to be assessed in some way. Decisions about pay and promotions have to be made. As researchers pointed out in a recent debate in Industrial and Organizational Psychology, “Performance is always rated in some manner.” If you don’t have formal evaluations, the ratings will be hidden in a black box.”

Job evaluations provide employees and corporate leaders the opportunity to gauge achievements based on mutually agreed to expectations. Sometimes performance is easy to measure and other times it can be more difficult when tangible results are not as obvious. Cultural fit is one of those intangible results that could be hard to measure and more subjective rather than objective. Clearly defining “organizational culture” and communicating this verbally and in writing leads to the effective use of the term, cultural fit, and how it supports corporate vision. Only then can employee reviews effectively include discussions about homogenizing with “fit” along with suggested modifications, if any. One would think including cultural fit as part of an employee evaluation is time well spent considering the costly investment of hiring, training, pay and benefits.

“Once the company culture has been defined, ideally every action, strategy, decision and communication should support the cultural beliefs, including all HR mechanisms from recruitment and hiring processes to performance review systems.” How Important Is Culture Fit For Employee Retention

When culture isn’t clearly defined, termination (or not being hired) could be perceived as a decision based on personal bias which may include non-compliance with the Federal protected classes. And, it’s possible one might conclude the decision was based on having different political opinions or lacking common (recreational) interests.

“And I’ve observed this.  Some executives I’ve dealt with over the past few years have used the phrase “not a cultural fit” in exactly this negative, let’s-maintain-the-status-quo way; to mean “that person is too black/female/old/young/non-degreed/linear/non-linear”…in other words, “that person is not enough like me.” Is Cultural Fit Just a new Way To Discriminate

We are experiencing a political polar divide today, which may be impacting working environment morale, affecting people functioning in close proximity sharing different viewpoints. It appears for this reason political views, personal and religious convictions might be on an invisible checklist for determining cultural fit. These reasons are not justifiable to measure a candidate’s potential or current employee(s) ability to succeed. Cultural fit should include performance, team member contribution, thriving as a team player, shares corporate vision, well qualified in skill, experience and communications. And, it is indeed possible to hire based on such qualifcations, without bias, reflecting richness of diversity.  In the article, How Important Is Culture Fit For Employee Retention, the author, a former Navy Seal, writes…

“That’s not to say that all SEALs are cut from the same mold. We have an extremely high level of diversity. Which brings me to an important point. Culture fit doesn’t mean that an organization is recruiting the same kind of people with the same backgrounds and experiences. Or at least they shouldn’t be.”

Here are possible considerations to safeguard against personal bias.

  • Clearly communicate company culture during the interview process as well as in employee handbooks, corporate mission statement and anytime the strategy of the company and its goals are shared. Identifying “culture” should include diversity of thought, perception, and experiences.

“Inclusive leaders understand that personal and organizational biases narrow their field of vision and preclude them from making objective decisions. They exert considerable effort to identify their own biases and learn ways to prevent them from influencing talent decisions. They also seek to implement policies, processes, and structures to prevent organizational biases from stifling diversity and inclusion. Without such measures, inclusive leaders understand that their natural inclination could lead them toward self-cloning, and that operating in today’s business environment requires a different approach.” 6 Characteristics of Inclusive Leaders

  • Schedule outcome focused performance evaluations. Include company culture in the review and note “fit” expectations to the business strategic model the company is pursuing for its success. The focus of the review to be on business skills, performance to goals, and style of communication/engagement with staff and customers (if applicable), which aligns with the description of corporate culture and fit. A signed copy to be kept by both manager and employee.

Keep performance review standards simple and consistent throughout the company. Managers and employees might avoid complicated reviews.

If your company practices informal “coaching” rather than management style reviews, keep record of discussions and suggestions that support performance and cultural fit – employee and manager.

“The future of the workplace depends on how successful these companies become at building out new systems that incorporate frequent feedback, open communication, and coaching.” Why The Annual Performance Review Is Going Extinct 

“High turnover or lengthy open positions? Could there be a “bias” hiring the best when hiring managers perceiving “best” as a threat to their own corporate status?”  3 Unconscious Biases That Affect Whether You Get Hired

Short term employment and sudden termination is costly to corporations. Consider the expense for employee search, interviews and hiring process, training, pay and benefits. Now imagine the cost of resulting lawsuits if sudden termination is not backed by documented performance and “cultural fit” is not defined and/or termination is linked to the protected classes? Can companies then become vulnerable to litigation? “Well, sometimes it’s whatever a hiring manager wants it to mean. And that can be a big issue, leading to poor hiring decisions fraught with bias or even legal liability.” Hiring For Company Culture, Here’s What You Should Know,

Just because litigation resulting from “cultural fit” may not have happened, doesn’t mean it won’t. Imagine the increase to corporate bottom lines if employee turnover and the risk of lawsuits could be avoided? If you are a C-Level Exec reading this post, do you know the $$$ your company spent on employee turnover in the past year, two years, 5 years? How does your HR Department view “cultural fit” and what is their active role to standardize hiring and termination throughout all subcultures in the company?

One would think having a diverse corporate culture best represents the customer/consumer/client audience being served. A diverse workforce can anticipate and strategize how best to meet needs and purchasing habits of ALL people, across the spectrum. So, why limit success through the narrow “cloning” lens that could accompany “cultural fit” misuse?

“Curiosity and openness are hallmarks of inclusive leaders, who hunger for other perspectives to minimize their blind spots and improve their decision-making.” WSJ Article, 6 Characteristics of Inclusive Leaders

Bring performance evaluations back or identify effective “coaching” processes and its documentation. Include cultural fit in the employee review AFTER your firm has defined culture, which is understood throughout the organization; hiring process, employee handbook, communications where corporate vision and strategy is discussed. Hire and maintain a workplace representing a wide audience of views and styles to cover all blind spots. Protect against personal bias. Create a healthy work environment, which role models the effective use of cultural fit in a dynamic way because diversity and success work in tandem.

Resources

Is Cultural Fit Just a new Way To Discriminate, FORBES, by Erika Anderson, March 17, 2015
Let’s Not Kill Performance Evaluations Yet, HBR, by Lori Goler, Janelle Gale, Adam Grant , Nov. 2016
6 Characteristics of Inclusive Leaders WJS, by Bernadette Dillon, director, and Juliet Bourke, partner, Human Capital Consulting, Deloitte Australia, May 4, 2016
How Important Is Culture Fit For Employee Retention By Brent Gleeson, March 29, 2017
Why The Annual Performance Review Is Going Extinct by Kris Duggan is CEO and Cofounder of BetterWorks, October 20, 2015UL 6, 2017
Hiring for Cultural Fit? Here’s What You Should Know, Nick Misener July 6, 2017,
3 Unconscious Biases That Affect Whether You Get Hired , Shana Lebowitz July 17, 2015

“Where, after all, do universal human rights begin? In small places, close to home. So close and so small that they cannot be seen on any maps of the world. Yet they are the world of the individual persons; the neighborhood they live in; the school or college they attend; the factory, farm, or office where they work. Such are the places where every man, woman, and child seeks equal justice, equal opportunity, equal dignity without discrimination. Unless these rights have meaning there, they have little meaning anywhere.”  Eleanor Roosevelt Former First Land and U.S. Delegate to the United Nations

 

 

 

Life Lesson

Cultural Fit – Definition, Origin, Intention, and Misuse

 

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Since my last posting on August 5th, I have been researching this catchall phrase after knowing several individuals dismissed from their jobs for not being a “cultural fit”. In order to share a summary of pertinent details, this topic will be covered in a three part blog, noted below. This posting covers Cultural Fit – Definition, Origin, Intention and Misuse. The other topics will follow weekly, September 26th and October 3rd, respectively.

  1. Cultural Fit – Definition, Origin, Intention, and Misuse
  2. The Rise of Cultural Fit and Decline of Performance Reviews – How to protect against personal bias?
  3. Discovering Your Cultural Fit

The goal of this trilogy is to inspire QUESTIONS employers could be asking in order to determine how “cultural fit” is being used in their organization today and changes to implement, based on any misuse of this term. Hopefully this writing will also reveal toxic “sub-cultures” within the organization when hiring practices are not aligned with corporate standards. Employees and job candidates, after reading this 3 part series, can be equipped to ask the right questions to determine their own culture match, too.  If a company is hiring based on cultural fit, we can suppose they very well can fire “at will” lacking in cultural fit, without notice or explanation.

Cultural Fit – It’s History, Intention, and Misuse Today

Definition: Cultural Fit – How it should be defined and practiced

Blending within a harmonized working environment for optimum productivity and performance results.

Understanding and expressing corporate identity, mission, vision and strategy with “how we roll“, sharing similar business core values and communication styles at the pace/rhythm set by corporate leaders, directors and managers – consistent at all levels of the organization.

Origin/History

First there had to be an identification of “corporate culture” before there could be the term “cultural fit”. The first recorded study of Organizational Culture was in 1961 by Burns and Stalker, identifying with a dependable constant system of shared beliefs that could bring positive results. Through the years, 1961 through 1992, many leading names in this field joined the discussion, which included behavioral studies of individual personalities, shared beliefs, and performance, along with conducting research to measure effectiveness of grouping in the workplace. All of this led to the corporate culture movement. Resource: On the Origin and Evolution of Corporate Culture by Eric Van den Steen, pages 7-8.

This is an excellent study that digs deep into the origin of corporate culture and probabilities (or not) of cultural fit correlating to increased performance.

“After this partial validation, I draw one important new insight from the model. I show in particular that there will be a correlation between cultural strength and performance, even when the homogeneity of beliefs has no direct impact on performance. This casts some doubt on the culture-based literature that cites such correlations as proofs that culture is valuable and then goes on to explain why it is valuable. While my analysis does not imply that homogeneity is not valuable, it suggests that care must be taken when interpreting such correlations.” Page 19

Intention

The history of organizational culture is complicated and includes psychological and behavioral studies and analysis. The intention of cultural fit, however, is quite simple…bringing skilled employees together with similar working personalities and styles in order to create a thriving working environment that will increase productivity and performance aligned with corporate vision and strategy.

This idea began in the 1980’s and caught on with gusto in early 2000. Simple examples of “culture fit” that align with corporate strategy could be hiring extroverts for fast pace growth or seeking introverts to align with company strategy for study, analysis, then growth. Another example might be to employ those who are risk takers or perhaps, looking to hire deep thinkers whose decision making is the result of study, discussion, and consensus.

Misuse

Cultural fit is a catchall phrase commonly referred to today. I can’t help but wonder how many use this term and do not know anything about its history, intended use, or studies conducted, which reveal its overall effectiveness or ineffectiveness. The following are some of the ways cultural fit is being misused today.

  1. Hiring managers and HR not able to define/articulate their own corporate culture yet hire and fire by the term, cultural fit.
    • Corporate culture description is not noted in the company’s mission statement, corporate vision, websites, and employee handbook or discussed during the interview process.
  2. Cultural fit becomes a filter for personal shared interests, political, and religious persuasion. This term can be used as a mask to avoid compliance to the Federal Equal Employment Opportunity Laws (EEO) which prohibits discriminating in hiring, firing or pay based on a person’s race, color, religion, sex, national origin, age, disability, genetic information, including sexual harassment.
  3. Firing employees for not being a “cultural fit” with no specific reason(s) or comparison to corporate culture. Vague responses are given … “a number of general areas, not one specific area.” Yet, the employee meets all MBO’s, aligns with corporate vision and strategy and thrives with co-workers.
    • This is when suspicion surfaces, based on (2) above.

How do you know if this term is being misused at your workplace? The following are some red flags.

  1. Confusing “Cultural Fit” with expected submission to authoritative “control” leadership.
  2. High employee turnover within some divisions, groups within departments.
  3. Unexpected and sudden employee termination(s).
  4. Referred candidates (outstanding skills and reputation) are quickly eliminated from the interview process, “not a cultural fit.”
  5. Unrealistic lengthy openings of job recs.
  6. No annual or bi-annual employee performance reviews therefore cultural fit becomes the norm for employment and job performance is not considered.
  7. Low workplace morale.
  8. Unwillingness of staff/employees to speak up due to fear of open and honest communication that may not “clone” executive team views.
  9. Interview focuses heavily on personal topics rather than corporate mission, vision and candidate’s business experience.

Corporate culture could be a good thing when it is used in tandem with job performance and it is clearly defined, understood and shared through all levels of the organization. Cultural fit becomes negative when used as a mask; a toxic working environment, compliance to federal discriminatory classes, and blocks hiring those with diverse business skills and experiences who don’t clone with a specific manager or department head.

As a corporate leader, do you know how your hiring Directors and Managers are using the term, “cultural fit”? How is the HR department establishing a standard for the proper use of this catchall phrase? Are red flags being ignored? If “cultural fit” is misused, although most states allow “at-will employment”, could your company still be vulnerable to costly lawsuits?

As an employee are you experiencing red flags? Is workplace morale low? Do you feel your ability to thrive is stunted when your “voice” is forced into silence because of fear? Are you aware of the process for reporting discriminatory practices and do you feel comfortable doing so without the fear of termination?

If you are a job candidate, take the conversation about cultural fit seriously. Ask during the interview, “Specifically, what are looking for to hire one candidate over another? If the answer is “cultural fit”, follow up with this question…”Can you describe your corporate culture and the ideal fit?” If this question is not adequately answered, do you feel it’s the right company for you? What is the risk you assume if offered the job and you accept?

Asking questions is a great place to start for companies to protect themselves and employees and candidates to protect their future. What is your plan, to protect your company as an employer or to protect yourself as an employee? It’s time we all consider cultural fit and its intended use.

Resources

On the Origin and Evolution of Corporate Culture by Eric Van den Steen, April 7, 2003
Guess Who Doesn’t Fit In At Work?  New York Times, Lauren A. Rivera, May 30, 2015
Culture Fit in the Workplace: What It Is and Why It’s Important by Dr. Kerry Schofield , published 2017
Hiring for Cultural Fit? Here’s What to Look For– Business News Daily, By Shannon Gausepohl,  Feb 27, 2017
The End Of Culture Fit Forbes, by 
Recruiting for Cultural Fit by Katie Bouton, July 17, 2015
Is Cultural Fit Just A New Way to Discriminate? By Erika Andersen, March 17, 2015
What is Organizational Culture – the results of a survey totaling 300 responses on the varied perceptions of “culture” – HBR, Michael D. Watkins, May 15, 2013
Is Rejecting A Candidate Because They Are Not a Culture Fit Really Just Thinley Veiled Discrimination? Quora, Gayle Lakkmann McDowell, April 3, 2014

 

Life Lesson

Cultural Fit

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In the past 6 months a few individuals within our circle of professional relationships have suddenly been let go from their jobs for this reason…”you are not a cultural fit.” At the time of hire the culture of the organization was not defined. Although the individuals excelled at their jobs and shared the same corporate vision and passion for the mission of the company, specific reasons for not “fitting in” to the company culture were not provided by the direct report or HR.

Concerned about what appears to be a new employment policy direction for corporate America, I recently skimmed the surface, doing some online research. Discovered this “practice” is far more prevalent than I had imagined, leaving me with the following unanswered questions.

  1. When did “cultural fit” first become a corporate hiring/firing practice and is this term being used today as it originally may have been intended?
  2. Could this “catchall” phrase be a mask to avoid compliance to the Federal Equal Employment Opportunity Laws (EEO), which prohibits discriminating in hiring, firing or pay based on a person’s race, color, religion, sex, national origin, age, disability, genetic information, including sexual harassment?
  3. Our country is experiencing a political polar divide between liberals and conservatives. Is it possible “cultural fit” includes filtering based on political allegiance?

It will take committed time to peel away the layers surrounding “cultural fit” in order to see the bigger picture and perhaps the vulnerability and risk to BOTH employees and corporations. For this reason, I’m taking time off from blogging to pursue this assignment and will return September 19, 2017.

I am grateful for the incredible response to my blog, Modify, since it began April 22, 2017. Thank you for your support, replying with comments and being an awesome audience to the articles shared. The blog WILL continue September 19, 2017. While I’m working on “Cultural Fit… In The Workplace”, I encourage you to share your feedback with me:

  • Have you (or someone you know) been fired or not hired because of cultural fit? Was cultural fit clearly defined through either the hiring or firing process? Can you share the experience with me?
  • Share your comments, if any, about how I might improve Modify and/or topics to consider for publication when I return mid-September, which fall within the Modify menu categories.

Thank you!! You can share your stories/feedback through email by clicking HERE.

Gratefully,

Debra