UO > Feature > Conduct an Ethics Audit

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Does this practice have a mission statement and an ethics statement? It’s a good sign if a potential employer has an ethics statement in addition to a mission statement, in writing, says Kay. “I’m big on qualifiers when asking the tough questions, such as, ‘I’m sure you’ve thought about this, because ethical issues are important in any practice...’”

Then, Kay says, pay close attention to how your questions are answered. If the interviewer hedges or tries to deflect the question with a long speech unrelated to what you just asked, a red flag should be raised.

Trevino agrees. “If a potential employer has given thought to these issues, he or she should be happy to talk about them or say, ‘I haven’t thought about that, but I’d like to bring you on board to look at that issue,’” Trevino says. “To that response, I would say, ‘Great!’ But if the interviewer starts hedging, you should take responsibility not to join that practice.” (For more information on putting together an ethics statement, see sidebar on next page, “Developing an Ethics Statement,”)

May I talk with a member of your staff to get a better idea of what it’s like to work here? “This may seem like a risky thing to do,” says Kay. “But most interviewers at good organizations will be more than happy to find someone for you to talk to. Your interviewer may even already have thought of this and has someone ready to go. Just remember, it’s unlikely you’ll be introduced to someone who would give the practice a negative review.”

Still, a person’s demeanor and tone can speak volumes, so speaking with another physician or two in the practice is always useful.

Counselors and career coaches say it time and again: It’s not just what is said during the interview process that matters, it’s also what is not said.

“Assess the atmosphere in the practice from the moment you walk through the door,” says Kay. “Are people welcoming to you? Are they courteous to each other or snippy? Are phones ringing for a long time before they are answered?” These things can be indicators of bigger problems with how the practice is run, she says.

Walk through the building and surrounding areas, too. If you don’t feel comfortable there, chances are a patient wouldn’t either. And that may translate to how a patient would feel about you if you were practicing there.

One way to get a better idea of how a practice operates before signing on full time (or even interviewing) is to ask to spend a week doing some unpaid “shadowing” physicians there, or take a weekend or evening moonlighting position, if one is available.

“The people I know who have done this before joining a practice full time are among the happiest in their jobs now,” says Waxman.

For Goldfarb, this trial period of practicing brings to mind a joke:

A man dies, and is invited to Heaven. He says, “Well, this seems great,

but I’d really like to check out Hell first.”

So he stops by Hell and sees beauty all around him…lush landscapes,
happy people, wonderful food.

Everything is perfect.

He goes back to Heaven and says,
“You know, I’ve decided I’m going to go to Hell.”

He signs in to Hell, only to find the most hideous place with fire and misery.
The beauty he saw the first time is gone.

He asks what happened.

“Well,” the guy in charge tells him,
“your first visit was the recruiting visit.”

“Seriously,” says Goldfarb, “shadowing or moonlighting is a good idea, and I know people who’ve done it successfully. But you do need to keep in mind that you’ll never truly see how it is to work somewhere full time until you’re actually in the position.” n

In their book, Managing Business Ethics: Straight Talk About How to Do It Right (John Wiley and Sons Inc., 2004), authors Linda K. Trevino, PhD, and Katherine A. Nelson suggest questions to ask potential employers.

Of particular note to physicians joining a large organization are the following:

1. How are organizational leaders perceived in terms of their integrity?

2. How do organizational leaders model ethics-related behaviors?

3. Are workers at all levels encouraged to take responsibility for the consequences of their behavior or to question authority when they are asked to do something that they consider to be wrong? How?

4. Does a formal code of ethics and/or values exist? Is it distributed? How widely? Is it used? Is it reinforced in other formal systems such as reward and decision-making systems?

5. Are whistleblowers encouraged and are formal channels available for them to make their concerns known confidentially?

6. Is misconduct disciplined swiftly and justly in the organization?

7. Is integrity emphasized to recruits and new employees?

8. Are ethical considerations a routine part of planning and policy meetings, new venture reports?
Is the language of ethics taught and used? Does a formal committee exist high in the organization for considering ethical issues?

9. Identify the organization’s heroes. What values do they represent? Given an ambiguous dilemma, what decision would they make and why?

10. What are some important organizational rituals? How do they encourage or discourage ethical behavior? Who gets the awards, people of integrity who are successful or individuals who use unethical methods to attain access?

11. What are the ethical messages sent to new entrants into the organization? Must they obey authority at all costs, or is questioning authority acceptable or even desirable?

12. Does analysis of organizational stories and myths reveal individuals who stand up for what’s right despite pressure, or is conformity the valued characteristic? Do people get fired or promoted in these stories?

13. Does acceptable language exist for discussing ethical concerns? Is this language routinely incorporated and encouraged in business decision making? n

After all of your homework and questions during the interview process, you’re impressed with the job opportunity. Your potential employer was impressed with the idea of putting together an ethics statement for the organization. She makes you an offer, emphasizing that she wants you — in a few weeks — to be in charge of putting together an ethics statement. Where to begin?

In their book, Managing Business Ethics: Straight Talk About How to Do It Right (John Wiley and Sons Inc., 2004), Linda K. Trevino, PhD, and Katherine A. Nelson describe the values statement as “a sort of ‘Ten Commandments’ for an organization.” To be effective, they say, the statement should be short, memorable, and in plain language. It’s essential, say Trevino and Nelson, that the organization’s own employees have input into its content. “A mission statement scribed by outsiders just won’t ring true and is likely to end up the subject of a Dilbert cartoon,” they write.

So enlist the help of colleagues, get a true feel for the practice’s culture, and run the final result by all of those who contributed to it. And don’t be shy about posting the statement prominently, where patients and colleagues alike can see it. n

Barbara Alden Wilson is a Philadelphia-based free-lance writer and a regular contributor to UO.

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@ 2004 UO Inc. www.uoworks.com 800-888-2047





						Conduct an Ethics Audit (continued) [ previous ] Does this practice have a mission statement and an ethics statement? It’s a good sign if a potential employer has an ethics statement in addition to a mission statement, in writing, says Kay. “I’m big on qualifiers when asking the tough questions, such as, ‘I’m sure you’ve thought about this, because ethical issues are important in any practice...’” Then, Kay says, pay close attention to how your questions are answered. If the interviewer hedges or tries to deflect the question with a long speech unrelated to what you just asked, a red flag should be raised. Trevino agrees. “If a potential employer has given thought to these issues, he or she should be happy to talk about them or say, ‘I haven’t thought about that, but I’d like to bring you on board to look at that issue,’” Trevino says. “To that response, I would say, ‘Great!’ But if the interviewer starts hedging, you should take responsibility not to join that practice.” (For more information on putting together an ethics statement, see sidebar on next page, “Developing an Ethics Statement,”) May I talk with a member of your staff to get a better idea of what it’s like to work here? “This may seem like a risky thing to do,” says Kay. “But most interviewers at good organizations will be more than happy to find someone for you to talk to. Your interviewer may even already have thought of this and has someone ready to go. Just remember, it’s unlikely you’ll be introduced to someone who would give the practice a negative review.” Still, a person’s demeanor and tone can speak volumes, so speaking with another physician or two in the practice is always useful. Nonverbal clues Counselors and career coaches say it time and again: It’s not just what is said during the interview process that matters, it’s also what is not said. “Assess the atmosphere in the practice from the moment you walk through the door,” says Kay. “Are people welcoming to you? Are they courteous to each other or snippy? Are phones ringing for a long time before they are answered?” These things can be indicators of bigger problems with how the practice is run, she says. Walk through the building and surrounding areas, too. If you don’t feel comfortable there, chances are a patient wouldn’t either. And that may translate to how a patient would feel about you if you were practicing there. One way to get a better idea of how a practice operates before signing on full time (or even interviewing) is to ask to spend a week doing some unpaid “shadowing” physicians there, or take a weekend or evening moonlighting position, if one is available. “The people I know who have done this before joining a practice full time are among the happiest in their jobs now,” says Waxman. For Goldfarb, this trial period of practicing brings to mind a joke: A man dies, and is invited to Heaven. He says, “Well, this seems great, but I’d really like to check out Hell first.” So he stops by Hell and sees beauty all around him…lush landscapes, happy people, wonderful food. Everything is perfect. He goes back to Heaven and says, “You know, I’ve decided I’m going to go to Hell.” He signs in to Hell, only to find the most hideous place with fire and misery. The beauty he saw the first time is gone. He asks what happened. “Well,” the guy in charge tells him, “your first visit was the recruiting visit.” “Seriously,” says Goldfarb, “shadowing or moonlighting is a good idea, and I know people who’ve done it successfully. But you do need to keep in mind that you’ll never truly see how it is to work somewhere full time until you’re actually in the position.” n SIDEBAR The Must-Ask Questions In their book, Managing Business Ethics: Straight Talk About How to Do It Right (John Wiley and Sons Inc., 2004), authors Linda K. Trevino, PhD, and Katherine A. Nelson suggest questions to ask potential employers. Of particular note to physicians joining a large organization are the following: the formal management system (what executive leadership says happens): 1. How are organizational leaders perceived in terms of their integrity? 2. How do organizational leaders model ethics-related behaviors? 3. Are workers at all levels encouraged to take responsibility for the consequences of their behavior or to question authority when they are asked to do something that they consider to be wrong? How? 4. Does a formal code of ethics and/or values exist? Is it distributed? How widely? Is it used? Is it reinforced in other formal systems such as reward and decision-making systems? 5. Are whistleblowers encouraged and are formal channels available for them to make their concerns known confidentially? 6. Is misconduct disciplined swiftly and justly in the organization? 7. Is integrity emphasized to recruits and new employees? 8. Are ethical considerations a routine part of planning and policy meetings, new venture reports? Is the language of ethics taught and used? Does a formal committee exist high in the organization for considering ethical issues? the informal (or underground) SYSTEM (what really happens): 9. Identify the organization’s heroes. What values do they represent? Given an ambiguous dilemma, what decision would they make and why? 10. What are some important organizational rituals? How do they encourage or discourage ethical behavior? Who gets the awards, people of integrity who are successful or individuals who use unethical methods to attain access? 11. What are the ethical messages sent to new entrants into the organization? Must they obey authority at all costs, or is questioning authority acceptable or even desirable? 12. Does analysis of organizational stories and myths reveal individuals who stand up for what’s right despite pressure, or is conformity the valued characteristic? Do people get fired or promoted in these stories? 13. Does acceptable language exist for discussing ethical concerns? Is this language routinely incorporated and encouraged in business decision making? n SIDEBAR Developing an Ethics Statement After all of your homework and questions during the interview process, you’re impressed with the job opportunity. Your potential employer was impressed with the idea of putting together an ethics statement for the organization. She makes you an offer, emphasizing that she wants you — in a few weeks — to be in charge of putting together an ethics statement. Where to begin? In their book, Managing Business Ethics: Straight Talk About How to Do It Right (John Wiley and Sons Inc., 2004), Linda K. Trevino, PhD, and Katherine A. Nelson describe the values statement as “a sort of ‘Ten Commandments’ for an organization.” To be effective, they say, the statement should be short, memorable, and in plain language. It’s essential, say Trevino and Nelson, that the organization’s own employees have input into its content. “A mission statement scribed by outsiders just won’t ring true and is likely to end up the subject of a Dilbert cartoon,” they write. So enlist the help of colleagues, get a true feel for the practice’s culture, and run the final result by all of those who contributed to it. And don’t be shy about posting the statement prominently, where patients and colleagues alike can see it. n Barbara Alden Wilson is a Philadelphia-based free-lance writer and a regular contributor to UO. 1 \| 2 @ 2004 UO Inc. www.uoworks.com 800-888-2047