Accountability can be a sensitive subject because most people like to think of themselves as responsible employees or managers. However, excuse-making and “waiting for things to get better” generally don’t improve a business situation. Here are some tips for fostering greater accountability within a hearing care business or practice.

Sadly, the “Blame-Game” has become a pervasive phenomenon in America’s corporate culture—with Enron, Tyco, and other companies epitomizing the increasingly popular sport of finger pointing among top management. In helping client companies build their businesses, I invariably meet Blame-Game players in all strata of the organization: the people who make excuses for non-performance, and the leaders who make their own excuses and accept excuses from their team. Several business experts believe that lack of accountability is the number-one challenge facing organizations today.1

Those involved in finger-pointing are the unwitting subversives who sabotage growth. According to John Miller, author of QBQ! The Question Behind the Question, “In today’s business culture, the lack of personal accountability is a problem that has resulted in an epidemic of blame, complaining and procrastination. No organization or individual can achieve its goals, compete in the marketplace, fulfill its vision, or develop people and teams without personal accountability.”2

Dave Kurlan, president of Objective Management Group, contends that “real growth and change will not occur until an individual stops making excuses and [takes] responsibility for their weaknesses.”3 While this may be easier said than done, it is important to identify and eradicate lack of accountability in the corporate culture—as well as in small and medium-size businesses— in order to promote growth.

Identifying Lack of Accountability
A number of examples can be cited to demonstrate the need for accountability. For example, one practices revenues had been declining for 4 years, and margins were creeping downward. Determined to stop the bleeding and reverse the trend, the management team requested an objective assessment of their organization’s business-development processes. The evaluation revealed that the entire team had a problem with excuse making—even the president/owner of the company.

Interviews with key players in the organization yielded commonly found accountability-ducking comments, such as blaming the poor economy, tough competition, or new management. These included statements like:

  • Why do patients expect so much?
  • When will the market turn around?
  • When is someone going to train me?
  • When is someone going to put together a decent marketing program?
  • When is management going to get its act together?
  • When are we going to become more competitive?
  • When are we going to have better products?
  • Why aren’t my people motivated?
  • Why do I have to do everything myself?2

In reality, when people blame the economy—an external element—they don’t believe they have control over the outcome and therefore aren’t likely to do anything that will improve their effectiveness. When competition is cited, it is really an admission of being outsold by the competition. When management is blamed by workers, it can often be viewed as a cop-out and failure to become committed to changing the situation or, at least, changing what they can change. As Kurlan explains, “They would be criticizing themselves if they were to take responsibility for not following through on something or letting something fall through the cracks.”3 In most cases, employees do have the ability to affect change.

The following are symptoms that may indicate the revenue-generation side of a hearing care business/practice lacks accountability and personal responsibility:

  • The patient management pipeline, or flow of patients from the first appointment to the fitting of the hearing instruments, is weak. This weakness is due to not enough new patients or not enough patients who are being adequately prepared to make a commitment to use amplification.
  • The dispensing professional always discounts price in order to get the business.
  • There is a low conversion rate from those patients who are qualified for amplification to those who make a decision to be successfully fit.

Toward Eliminating Lack of Accountability
There are four effective ways to eliminate lack of accountability while building a culture of personal responsibility in the workplace:

  • Hire the right people;
  • Set the right expectations;
  • Ask the right questions;
  • Match the right behaviors.

Hire the Right People. Jim Collins’ research for the book Good to Great4 identified a set of elite companies that made the leap from good to great and maintained their results for at least 15 years. After the leap, these good-to-great companies generated cumulative stock returns over 15 years that outperformed the general stock market by an average factor of 7 times. Although these companies are significantly larger than hearing health care businesses, some common principles still apply. One of these principles is to get the right people involved in your organization.

Although recruiting personnel was discussed in detail by the author in a previous HR article,5 having the right people cannot be over-emphasized as a critical component in creating a high-performance, revenue-generating team. Disciplined people, who operate with a high degree of personal responsibility (ie, they don’t make or accept excuses for themselves or others), have disciplined thoughts, which fuel disciplined actions, which fuel disciplined results.5

We’ve often heard the comment, “People are your greatest asset.” Interestingly, the good-to-great leaders think differently, stating that the right people are a company’s greatest asset. Collins contends that “if you have the right people, management and motivation problems go away because they have the inner drive to create excellence.”4

Case in point: A client company had a growing gap between their business plan’s revenue projections and year-to-date results. A visit with the owner revealed that he was quite proud of the leadership team he had recently put together. Each person had more than 25 years of experience in the industry with excellent technical expertise and a good track record. However, each new member of the leadership team blamed their lack of recent success on the flat economy in their respective markets. During the assessment phase, we discovered that they saw the economy as an obstacle—versus a stepping-stone—to creative brainstorming and strategy. The outcome? Disappointing results. It’s true that the economy can help determine business success and failure. However, people with the right thoughts about personal responsibility would have taken action to deliver better bottom-line performance in the face of poor economic circumstances instead of accepting under-performance as an “inevitability.”

Set the right expectations. Like the president of the above company, it is often easy to accept excuses. What can we do to turn the tide and create a culture of accountability in our individual practices? Since insisting on worker accountability is one of the most dreaded and confrontational of all management responsibilities, what can a leader do to actively build a team of “right” people?

Kurlan3 says the answer is to recognize excuses and stop accepting them. “Effective immediately, you must stop accepting excuse-making of any kind, from any one, at any time, or for any reason—even if there is a shred of validity to it!” says Kurlan. He advises clients to raise expectations by asking, “If you couldn’t use that excuse, what could you have done differently to overcome that obstacle? This strategy empowers your people and forces them to hang in there and work harder and smarter, knowing that you won’t accept that excuse ever again.”3

For example, an I.T. (Information Technology) company for whom I consulted has experienced steady growth over the last 3 years in spite of the “IT-bust” and the languishing economy. Why has this company been successful when many of their counterparts are either out-of-business or operating in the red? Barb, a principal in the group, says “When we get discouraged about what we see in the marketplace, we ask each other, ‘What can we do differently so that the slowing economy becomes a stepping-stone to growth?’” The result? Steady growth in a market where many companies have failed.

Ask the right questions. The next step is to train yourself and your staff to ask empowering questions. John Miller2 in QBQ! recommends the following:

  • Begin with questions that use “What” or “How” (not “Why,” “When,” or “Who”).
  • Use questions that contain an “I” (not “they,” “them,” “we,” or “you”).
  • Focus on action.2

For example, by using the principles above, the blame questions identified earlier are transformed to become:

  • What can I do help set proper patient expectations?
  • What can I do to jump-start our market in my community?
  • What training do I need to move my skills to the next level?
  • How can I improve our marketing plan?
  • What can I do to differentiate my practice in this community?
  • How might I do a better job of instructing the patient?
  • What can I do to create a more motivated environment?2

Another example: After determining that rampant excuse-making was causing his business to stagnate, Tom, a vice-president of business development for a medical device company, decided he needed to change his own behavior if he expected his people to change their attitudes. Tom posted Miller’s QBQ! principles2 on a large poster in his office. When necessary, as his staff posed self-defeating questions to him, he’d simply point to the poster requesting that they reword the question in a QBQ! format.

Simply put, there are some questions that will get a person and an organization nowhere. In contrast, questions having potential answers that can empower individuals often lead to great personal and professional gains.

Match the right behaviors. Accountability can be promoted in many ways. However, to build a culture of accountability, leaders need to develop an accountability process that includes (at least) the following:

  • Match the right behaviors and to the desired outcomes.
  • Monitor performance.
  • Measure against key accountabilities.

Research by Objective Management reveals that, in organizations committed to developing consistent growth in revenues, 25% of a manager’s time is spent holding people accountable and measuring their performance.3 This may be uncomfortable for some managers, but it is an essential function of being a manager. Truly being a manager begins with defining workers’ desired outcomes. Steve Montague of Effective Sales Development, a consulting firm based in Kansas City, says that he instructs clients to identify the 3 to 5 “key accountabilities” for each employee’s position. Then he asks the employee in that position the same question, “What are the 3 to 5 key accountabilities that you need to perform in your position?” Frequently, clients are shocked at the mismatch they discover between the answers. It quickly becomes apparent why employees are not achieving the desired outcomes; they are not striving for the same outcomes that management deems essential for success.

Numerous tools exist to enhance the accountability process. Montague recommends a non-traditional performance appraisal system that is not tied to salary increases, but rather tied to the education and development of the person. Often companies use the performance appraisal process in a happenstance manner for pay increases. Montague, in contrast, encourages regular and consistent performance reviews that encourage employee growth and communication. “With a good system in place we can coach, mentor, and train the individual to higher levels of success in or out of the organization,” says Montague. “Whichever it is, it will be with the best interests of both the individual and the organization.”

Another effective tool in matching, monitoring, and measuring the performance of revenue-generation employees is the “Scorecard.”6 This method identifies the key accountabilities of a position, defines good/better/best performance standards, and measures performance. Peter Drucker, often referred to as one of the greatest management thinkers of our times, suggests that few factors are as important to an organization as measurement, and that measurement is among the weakest areas in management today.3 A number of handy management tools exist, and the Scorecard is an example of a tool designed to assess employee accountability and communication.

For example, a recent client named Jackie, coming from an operations background and now vice president of a practice, knew there must be metrics—measurements by which she could assess whether people were on track to achieving the practices revenue objectives. However, none were available. A year later, after much dialogue and documentation using the Scorecard, Jackie is confident that her staff can grow to the next level. More importantly, she’s developed vital management tools, a scorecard, and a pipeline management process that help her identify problem areas and ensure clear expectations.

In The Oz Principle: Getting Results Through Individual and Organizational Accountability,1 authors Connors, Smith & Hickman summarize the difference between great and ordinary companies:

“A thin line separates success from failure, the great companies from ordinary ones. Below that line lies excuse making, blaming others, confusion, and an attitude of helplessness, while above that line lies a sense of reality, ownership, commitment, solutions to problems and determined action. While losers languish below the line, preparing stories that explain why past efforts went awry, winners reside above the line, powered by commitment and hard work.”1

The authors caution that excuse-making and a severe lack of accountability has weakened the American corporate culture, which now stresses ease over difficulty, feeling good over being good, appearance over substance, and saving face over solving problems. Further, they state that there is a great need to focus more on long-term solutions, total quality, and overall process rather than strictly on short-term results and quick-fixes.1

Accountability is essential for getting people to rise above their circumstances and do whatever it takes (within the bounds of ethical behavior and personal well-being) to get the results they want.

Correspondence can be addressed to HR or Danita Bye, Sales Growth Specialists, 1160 Cherokee Road, Long Lake, MN 55356; email: [email protected].

Danita Bye is president of Sales Growth Specialists (SGS) Inc, located in Minneapolis, a company that specializes in helping business owners increase their revenue-generating capabilities.

1. Connors R, Smith T, Hickman C. The Oz Principle: Getting Results Through Individual and Organizational Accountability. Englewood Cliffs: Prentice Hall; 1994.
2. Miller JG. QBQ! The Question behind the Question. Denver: Denver Press; 2001.
3. Kurlan D. Objective Management Business Development Overview. Available at: Westboro, Mass: Objective Management Group; 2003.
4. Collins C. Good to Great. New York: HarperCollins Publishers Inc.
5. Bye D. Five steps to building a great team. Hearing Review 2003; 10(7):28-31.
6. Kaplan R, Robert S, Norton DP. The Balanced Scorecard: Translating Strategy into Action. Boston: Harvard Business School Press; 1996.