Ron Ventura at Mitchell Memorial Hospital - Organizational Development

Submitted September 23, 2018: Russell S. Geller

Ron Ventura at Mitchell Memorial Hospital – Case Study

FRANK V. CESPEDES & HEIDE ABELLI - 2013

A Study of Organizational Development

Problem Statement:

Andy Prescott, chief of the Cardiovascular Center at Mitchell Memorial Hospital has hired Ron Ventura, a nationally recognized vascular surgeon to be chief of their vascular department. After numerous complaints from doctors and nurses about Ventura and after a 360-degree performance review cycle Prescott is now faced with the following dilemma: shall he renew Ventura’s employment contract. Prescott now wonders if Ventura is a good fit for the “team” regardless of his outstanding surgical performance and high rate of income generated by his caseload.  Also Prescott needs to figure out if Ventura’s behavior is the cause of these complaints. The crux of the issue may center on Ventura’s behavior violating the cultural norm of the hospital that focuses on team work and collaboration.

Hypothesis Statement #1

Abrasive personality – although a talented and national recognized vascular surgeon Ventura suffers from abrasive personality traits.

• Although Ventura’s work was on par with his nationally recognized reputation and he generated over $3.2 million in revenue it also had a positive halo effect for the entire hospital. Ventura’s behavior made it difficult for others to work with him. In fact it was causing other doctors and nurses to reconsider staying employed at Mitchell hospital.  Some residents had actually left their program after continued interaction with Ventura and his continued abrasiveness which was non-stop. Mitchell hospital had made strides in establishing a culture of teamwork and collaboration among the staff with emphasis in quality of care for their patients. In fact under the leadership of a new CEO, McAdams MD, the hospital was in the midst of a total revamp of its organizational structure – actually establishing “Team Mitchell” a new code of conduct.  Prior to McAdams’ leadership, the hospital’s administration had not been particularly concerned about cultural issues, expectations regarding physician conduct, or the extent of collaboration among the physicians, staff, and management. (Cespedes and Abelli – 2013 Page 2)
• In Harry Levinson’s The Abrasive Personality – 1978 we are told of the characteristics of the abrasive personality which Ventura’s Evaluation Packet mirror- there were numerous instances or examples of abrasive personality demonstrated by Ventura as typified by his colleagues. Quoting Levinson “such a person is most usually extremely intelligent.  With a passion for perfection accuracy and completeness he pushes himself very hard and can be counted on to do a job well, often spectacularly. He tends to want to do the job himself, however finding it difficult to lean on others who he feels will not do it to his standards on times or with the required finesse. (page 87). This one quote alone describes exactly has Ventura has acted without going into the numerous examples of his abrasive personality as cited in his evaluations by colleagues.
• Enabling the abrasive personality - One thing we have learned is that if no one ever confronts the abrasive personality than it will continue to permeate and have negative effects on those around. Andy Prescott who had hired Ventura even demonstrated this “ I tried to be diplomatic and give advice in an understated way.  I didn’t want to confront Ron head on. No one did….I wanted to cut Ron some slack.  I had made the decision to hire Ron and I needed it to work out.”   (Cespedes and Abelli – Page 5 ). This lackluster attitude played into Ventura’s behavior even more when it really began to create problems.  Prescott’s inability to take a heavy handed approach to the situation – helped contribute to the situation. Interestingly Prescott knew Ventura’s behavior was incorrect and the lack of reeling Ventura in would clearly demonstrate to the Staff at Mitchell that Ventura’s behavior was in fact acceptable. “ …am I in effect telling everyone that behavior doesn’t count – and that we put caseload, ability to generate revenue for the hospital, and prestige ahead of how we treat each other ?” (Cespedes and Abelli – Page 6)

Recommendations

Ultimately there is no easy solution to a problem or more so this particular situation.  However in the instance of Abrasive Personality there is almost every time an easy first step.  Instead of being passive one needs to be more direct and confront the person who is exhibiting the abrasive personality.  If Prescott would have been more concerned with fixing Ventura than worrying about the stature of the department and the income now generated then he would have had less issues with other members of the staff including those threatening to resign from Mitchell.  Levinson echoes this solution in his article and goes into detail on Page 90. “ However, if despite the boss’s best efforts the subordinate does not respond, the manager must tell him in no uncertain terms that his behavior is abrasive and therefore unsatisfactory.” This tactic would be my recommendation to Prescott.  Step up, speak up and do the right thing for all concerned parties.  We can never be concerned with satisfying one but we need to think of the needs of many.

If Ventura does not have “sight of the problem” then he should be told by Prescott.  In the long run this will make it easier for Ventura to identify the cause of all the complaints by his colleagues and help identify what he needs to worked on.  Only then will Ventura have a chance in improving his behavior.  There is however a chance that this course correction will not work and then a whole other discussion will have to take place – one such as can the abrasive personality actually be tolerated – the pros (that income and prestige generated) will have to be weighed against the cons (the toll it will take on moral of the staff and sense or lack of teamwork.)

Hypothesis Statement #2        

VABEs (values, assumptions, beliefs and expectations) – once again although Ventura is a talented surgeon he and the hospital staff have a distinct and delineated difference in VABEs.

• This hypothesis discussion will help understand the basis for Ventura’s current behavior as abrasive as it may be towards others.  To help us understand this discussion we will reference the article by James Clawson – Why Do People Behave The Way They Do – 2001.  VABEs are developed through many essential building blocks.  With a discussion of VABEs we learn to understand the root of the behavior.  Be it genetic endowment, memes, motivation or the REB Model we know one thing for sure: as cited on Page 14    “ Drawing Conclusions: The key to understanding why people behave the way they do is in the comparison of what they see and why they believe ought to be – the comparison between one’s perceptions and ones VABEs.”
• Growing up Ventura never imagined that he would be a surgeon and was the first in his family to go to college. As he became a medical resident he witnessed many other residents dropping out of the surgery program.  “There was a certain thrill of victory when I got through each year.  It was like a part of some elite military unit that had survived to fight the next major battle.” (Cespedes and Abelli Page 5).  Next stop for Ventura was a fellowship in a vascular surgery program at a heart hospital in Texas.  Here Ventura related upon his experience with his superior at this hospital. “That man had been a surgeon in the army for 15 years and it was here that Ventura learned about “command and control” in the OR.  “ He order me around like I was a Buck Private but he taught me everything he knew…he was the hardest on me because he thought I had potential……He’s the only person in my life I ever wanted to impress and sometimes in the OR I think about him and it makes me a better surgeon.” (Cesoedes and Abelli –  Page 5 ).  One can say that Ventura’s behavior was nurtured by his association with the former Medical Surgeon, his superior when he was a resident.  I believe it is a clear example of a meme – where Ventura’s behavior was influenced by behavior of another that had a clear effect on him.  Memes by definition are the ideas and beliefs that people develop and pass on to others over time.  This is a clear illustration of what happened to Ventura.  
• Ventura at times also claimed that Mitchell hospital was focusing on the wrong things -that in the operating room form didn’t matter – substance did and there was no room for “please” and “thank you”.  Once again behavior that Ventura demonstrated most probably since he “learned” or acquired it in his “buck private” days when he was a resident. The army surgeon was his mentor and most definitely influenced his VABEs. It is difficult to think that Ventura can change his ways since his VABEs were established at early point in his surgical career.  At this point in time being the leader of his department and seeing such professional and monetary success it may be difficult for him to adapt to the VABEs surrounding him – the VABE’s of others which seem to align more directly between the other colleagues and the hospital with its “Team Mitchell” mentality. It may be possible for Ventura to recognize that his VABEs don’t align with the others and that they are significantly different but I feel that due to the nature of his make-up and the fact that he practices narcissistic ways – I don’t think he would see them by himself.  Even if Ventura looked in the proverbial “mirror” he would miss it / he would not see it. He is blinded by his own VABEs.

Recommendations

Once again any recommendations will ultimately be not easy to implement.  We have learned that Ventura’s behavior was formulated in his formative years and he was “taught” that this way (possibly the abrasive way) was the correct way to act towards subordinates and this methodology would lead to success.  He was also taught to be his own man with his own leadership style that mirrored his mentors.  However in actuality this behavior would be an obstacle to his personal success.  Ventura needs to take step back and realize that his VABEs are not aligning with the others and needs to adjust his attitude for greater success.  It is clear that in his formative years Ventura was a student of negative interactions of VABEs and as he went on in his career began to practice these types of VABEs more and more. Ventura needs work on team skills which is the cornerstone of Mitchell hospital.  If nothing changes Ventura’s behavior will continue as long as such behavior is condoned (Cespedes and Abelli – Page 10)