Collaboration

Decisions hardly ever effect just the person making them. Anyone that has been in the military can attest to either enjoying or suffering under the decisions of others. That being said, you don't see too many generals asking privates their opinions on how the war should be ran, though there may be some validity in doing so!

All of us are tasked with decisions on a daily basis and these run from the mundane to the sometimes serious. Do I go to the grocery or make do with cereal for dinner? Do I respect the wishes of my spouse and remove life support or do I respect the wishes of her family? Thankfully most of my day to day decisions have more to do with the grocery side of the scale than anything else though I have had to make choices regarding my health that were serious in nature. 

Decisions are funny things in times of serious crisis. I had to decide, at one point, if I was going to undergo surgery for an infection in my intestines that had created a rupture and an abscess. The condition is a common one called diverticulitis but in may case the rupture was causing some serious problems. The resulting infection, if left untreated, could have led to death. The treatment is straightforward though not much fun as the antibotics can be very high powered and it seeemed that my infection was also a superbug which required extra heavy duty drugs to knock out. Where the decision came in was afterwards, did I have a portion of my intestines removed to lessen the chance of further infection or do I leave it alone and treat subsequent infections with antibiotics? The surgery was laparoscopic but the recovery was sure to be painful. All I really wanted was a better quality of life. At the time I was also in school and knew that the surgery would likely mean that I failed a class. 

When it comes to health there are a great many stakeholders. My mother, father, and all my other family are one. My loved ones that are not family are another, then my friends. Moving down the list were my co-workers. I suppose if I really wanted to get exact with stakeholders the bank that held my mortgage are another. That being said, had things not worked out I wasn't too concerned with the bank. They seem to be doing ok. 

I mostly conferred with family and loved ones. Stakeholders perform an invaluable service in the form of perspective. In a great deal of pain mu judgement was clouded and seeing as how I was in the hospital for just under 30 days my family and friends took care of my dogs, my house, and even had my car washed. Towards the end I was thinking of refusing services and just going home. I was emotionally and physically exhausted but my family and friends kept me focused and I persevered. The effects of that choice are still being felt today as this degree has taken much longer than I had anticipated and my poor digestive system still isn't at %100 but it is far better than it would be had I not gone through with surgery. 

Stakeholders force one to look beyond the immediate and that larger scope is also invaluable. Going along with that larger view comes more information. And for someone that has a sense of duty, stakeholders can bring boundaries that restrict negative actions. In many ways I feel my surgery serves a metaphor for how I view my life. Some things are just bigger than the individual and I feel this is at the heart of stakeholder viewpoints. It seems odd to use stakeholders as a term for my loved ones but they do have an investment in my well-being. 

Since then I know that given that there are things bigger than me I try always seek that bigger picture. I want to make sure that I have as much information as possible and that my judgement isn't being clouded by my own bias. I make sure that my friends are diverse and from as many walks of life as possible in order that I don't become stuck in my own ways of thinking...and I can be rather stubborn. 

While my story above isn't exactly in the letter of leadership or management I do feel that leaders are shaped by what happens to them. A person can take a personal experience and expand it to other parts of their life. Could I have been a good leader without surgery? Maybe. But I do know that having had it and understanding both myself and how I affect more than just me...I certainly am a better person. And since leadership is about first knowing yourself, I shall be a better leader for it. 

Self-Managed Teams

Self-managed teams are exactly what they sound like: teams that manage themselves to accomplish a certain task. In the course of both my undergrad and now my masters, self-managed teams have been addressed on a number of occasions. The linked video will offer some insight into the benefits of such teams but as for me, I don't need much more convincing.

It should come as no surprise to my professors and maybe the one non-professor that reads this blog that I am fan of Complex Adaptive Leadership. At its core CAL seeks to minimize managerial input and states that teams with defined boundaries and goals will produce the best possible outcome though it may not be the result that was desired for. This video demonstrates complexity theory as it applies to leadership in a succinct manner. More on the concept can be found here as well. There is more to the concept than I have written here otherwise an entire course at Embry-Riddle would not have been devoted to it. I bring CAL as it is a type of self-managed team and does more to crystallize the dynamics that occur between people than simply saying that managers need to get out of the way because that isn't the case.

A self-managed team does well when it has defined goals and a boundary in which to work. A team sorting out the best widget doesn't need to be tinkering around in marketing though in some cases it may be useful for marketing to know what fantastic things the widget people are doing. So if our widgets aren't functioning in an appropriate widget fashion our widget team doesn't need a manager directing all their actions. Instead the manager says, "our widgets are not widgety enough and I need you guys to fix it" The manager then may set a few boundaries such as budgetary constraints or materials available and then the manager gets out of the way. Or, in some cases, the self-managed team has flexible leadership where leadership is shared depending on the task at hand. When the team is working on the flux capacitor portion of the widget the flux capacitor girl is a nominal lead, when the problem moves to ensuring the widget, with its functioning flux capacitor, can make tasty espresso the espresso guy takes over and provides some direction. These are not assigned leadership roles but more the team making the best use of its potential.

The benefits of such teams is that they are efficient and will often solve problems in creative ways. Where they can be difficult is if the personnel involved are not comfortable working in a team or if the team gets stuck in a state of development like storming. These are mostly personality conflicts and given time many can be overcome. Time-sensitive actions may not be best handled by a self-managed team that is not established. In essence, you have to develop the team as an entity and then worry about the problems it will solve. Such an approach is very difficult for managers as they often have their own set of pressures to which they need to attend. Also, managers must learn to manage less and provide more support. Lastly, a manager must learn to trust the team's results. All of these things are easier to type than they are to do.

My work unit is largely self-managed though we do get directed around a bit at times; mostly on time sensitive or crisis issues. For the most part though, we are free to accomplish task as we see fit. I sometimes go along on things that aren't in my assigned duties simply because we function better as a team and just by being there we can help each other. It also doesn't hurt that I may learn something new!

Self-managed teams are great at finding creative solutions to problems and managers should develop a healthy trust for these teams. All in all I enjoy working with the team with whom I work. I was hired as much for my personality as I was my skills and that is something that managers will need to develop in themselves...how to interview for personality and learn to trust that the skills can follow. To be sure a baseline knowledge must be there as well as education but a manager can throw a rock and find a human resources specialist or an accountant. For that matter, none of us are really irreplaceable. It may be more difficult to find a skilled surgeon or an astrophysicist but such specialized skills are a league of their own. For most of us it is more how we work with each other that determines the outcome of our work and that is something that successful leaders understand.

EcoSeagate and Team Development

Seagate is a software company that, ever year, sends 200 of its employees to New Zealand on a team building experience. During this experience the team undergoes physical, mental, and quite possibly emotional tests. For five days the 200 employees are forced to work together in order to accomplish goals and for high-performance teams, accomplishing tough goals is the order of the day.

There is a certain value in teaching people about themselves. EcoGate's challenges are designed to force people to look inward as well as form bonds with one another and I think that last item is the most important. Forming bonds is something that transcends loyalty to company. CEO Bill Watkins learned from his Army days that people will not sacrifice for some vague idea like patriotism and or "Army" and in my own experience with the military I have found that to be true. I typically did what I did because the guy or girl to the left or right of me was doing it too. I didn't want to let the team down; I could have cared less about what happened to the Air Force as a whole. I still feel this way, I'm loyal to the organization I work for only to a point. In the end, its the team that I work with that motivates me to go to work every day.

Forming bonds with co-workers also adds to an informal information network that can be tapped when encountering difficult situations. So in that sense, these retreats also bring value. Value is something more than a dollar amount though I wonder if the stockholders feel the same way. It is personal opinion but I tend to think that if less emphasis was placed on the stockholder and more on the stakeholder there would be less of the issues we see companies facing.

High-performance teams tend to be goal focused and learning how to accomplish a difficult goal without tearing into one another is of huge value. While some tension in attaining a difficult goal is unavoidable knowing one's self can make that tension easier to handle. That being said, having fun in New Zealand is far different than meeting a goal on a factory floor or while designing new hard drives. One does not always translate to the other so I am skeptical as to how much a high-performance team really gains from this sort of thing. For that matter, I shy away from the term high-performance as that really just seems to be a label that teams give themselves in order to sound better. Every team is a high-performance team if it is accomplishing its goals. A team of janitors that does an excellent job is no less high performing than a team of engineers designing a hard drive. We use the term high performance more as a way to set apart the end result of the team's efforts from lesser important goals. To be sure a full trash can isn't going to bankrupt a company but that doesn't mean that janitors should not be encouraged to take pride in their contributions and their efforts.

Soapbox aside, I am not sold on the idea that these retreats add to the cohesion of teams away from the retreat themselves. What they can do is provide better tools for people to use provided they have the insight to find them within themselves. A skilled practitioner can help people find those parts of themselves as insight isn't gained without feedback.

My organization could do with many things but I don't think they are to the point where they've mastered the basics of allowing a team to be a team. In my unit we are separated from the hospital geographically and we've held our own team building activities, usually in a bar as we aren't being funded for trips to New Zealand. Our team functions well but I do think that is because we allowed to do our own thing just so long as our goals are being met. In that regard senior leadership is comfortable leaving us to ourselves. However, some of that is because we are far enough away we can ignore some of is directed at everyone else.

Decision Making And Conflict

The bigger issue that I see with conflict in regards to decision making is that people view far too many decisions as some sort of zero sum game. To be sure there are areas where decision making is zero sum as there are only so many dollars to spend or widgets to be made. Leaders on a battlefield certainly face grave consequences where lives are on the line. However, for the most part, interpersonal conflict is something where the emotional investment in a given position can outweigh the practicalities of a situation.

Stewart Levine's 10 principles of new thinking offer ways to re-frame common conflict variables. These are such re-framings as abandoning scarcity and instead looking at the abundance. However scarcity of resources often happens so I tend to find this a less useful principle. Others are much more useful such as turning enemies into friends or leaving secrecy behind and disclosing feelings (important in relationships). What I don't like is that these principles assume that everyone is playing by the same rules. Anyone that has engaged in tense business negotiations or had to make very difficult command decisions can tell you that relying on logic can be more useful than relying on feelings. Intuition, however, can be very useful at times so learning to blend logic and intuition may be more useful than simply abandoning reason and feeling one's way through a situation. I don't think Levine argues for such extremes but there is a danger in attempting neatly classify modalities of thinking. If anything, I argue that flexibility of thought and an understand of how emotion clouds decision making is a more useful way of thinking. I like to think that is in the spirit of Levine's model.

Without baring all the details I can say that in my former marriage I allowed to many emotional responses to cloud my thinking. My wife would want us to do something that I may not have enjoyed and instead of working to find a common ground I would become stubborn. With a certain amount of age and perspective, as well as education oddly enough, I learned more of what drove my responses and through that insight was able to abandon negative reactions to emotions. I still have my moments of stubbornness but now I know to place myself in the other person's shoes and take a look at things from their perspective.

I think that does along with what Mr. Levine is attempting to say. Had I been less concerned with winning or my own bravado I would have had a healthier relationship with my ex-wife. The marriage may or may not have worked out but at least I wouldn't have been left with the feeling that I was not the best person I could have been.

Conflict exists in all manner of human interactions and it really isn't a good or bad thing; it just simply exists. That being said, not all conflict is something that can be handled with Levine's 10 Principles. There are times when real-world implications are such that someone will win and someone will lose.  That does not, however, mean that EVERY conflict need to be treated as such and I think that is where many people, including myself, have made mistakes.

Brainstorming with Jobs

Shortly after Steve Jobs was removed from Apple, he and select few co-workers founded NeXt in order to market to schools. This video showcases Jobs and his team brainstorming how to get their product to market. It starts getting interesting when it gets to crunch time for the deadlines and with dwindling resources. You can also start to see Jobs' notoriety for being a less than pleasant person start to manifest itself. What can't be denied is that Jobs had a vision and while it is my opinion that Jobs' vision mostly was to take someone else's ideas and then, admittedly, improve on them his driving personality is very much on display in his younger years.

Throughout the video I noticed that the casual atmosphere and informal brainstorming didn't produce much and while we know that NeXt was bought by Apple in 1996 the success that NeXt would find isn't easy to see in the last bit of the video. Jobs saw his role as the grounding feature of a team of technicians that had belief but very little idea of how to make belief a reality. Founding a company is a tremendous undertaking and you can see how Jobs knew these hurdles but allowed the team to start to see them for themselves.

Earlier in the course we undertook a survey that was designed to showcase our managerial traits. For me, this was interesting but I don't place much faith in personality surveys, especially the Meyer-Briggs as much can depend on mood when answering the questions. That being said, it was consistent in much of my results that I tend to push boundaries. The debrief stated that I enjoy know what the rules are and that may be true but that is generally so I know which rules I can break and which rules I can merely bend. Additionally, I had high creativity scores and I do enjoy the arts and have great respect for anyone that creates; be it art or technology. Part of my disdain for Steve Jobs is that he didn't so much create as he stood on the shoulders of giants and improved their hats.

Brainstorming sessions like the one portrayed in this video are some of the most enjoyable aspects of problem solving for me. My debrief indicated that I tend to take process improvement seriously and in many ways I simply find it fun. I like nothing better than taking things apart to see how they work and with people-orientated processes you can often put the pieces back together in new and creative ways.

With regards to the video one can start to see the beginnings of group-think. That doesn't mean that it occurred but the seeds were there. One of the things needed for group-think to occur is that there is a strong leader that needs to be appeased. As the frustration builds you can see Jobs becoming much more task focused. This isn't a bad thing but if other group members start to see appeasing the leader as more important than delivering a good product the results can be less than satisfactory. We know from history that Steve Jobs went back to Apple and that Apple is one of the more successful companies in its field so something went correctly somewhere along the line. Bringing that back to what I know about myself is that I always make sure that someone is playing devil's advocate in any process improvement session that I am in. Sometimes that advocate is me and that suits me well as I sometimes learn more about a process by discussing the ways in which it can fail.

Overall, I don't think that I would have done well in the NeXt startup. I push against the rules a bit much for some leadership and I don't think that would have fit in well with Jobs. Additionally, the subject matter is not one in which I have a great passion.

Dan GIlbert Revisited

We discussed Dan Gilbert in week one and we are revisiting him again here in week five but also adding in protected values.  The previous post listed three protected values that I hold and ranked them in order of how likely I was to trade one of those values away for some other gain. What Dan Gilbert talks about is how people are conditioned to make bad choices. This seems particularly relevant when discussing protected values. 

Not everything in life is a zero sum game. If one group gains the right to vote, you haven't lost your right to vote. If one group gains the right to marry, your marriage isn't suddenly annulled. However, in leadership roles there are times that things might be zero sum. You can only have so much in the way of resources and finances. When choosing to allocate shipping you may run low on trucks. Or even deciding to whom to give the limited amount of money allocated to raises are all zero-sums. 

When someone holds a protected value so tightly that they cannot compromise it skews the equations that Gilbert uses to make his points. Some may find this worse than others. I may fire an excellent producer if he is racist. I can always train another to produce and the overall productivity of a department may increase if a toxic person is gone. So in essence, I don't feel that I lose anything by firing a racist. However, my third protected value is courtesy and if I fire someone simply because they are a little brusque I may dent productivity more than I gain anything in return.

In other words, and as Gilbert mentions, rational decision making can be adversely affected by emotions. Not that protected values are emotions but strong emotions can be brought to the surface when protected values are challenged. Managers and leaders should be aware of how far they are willing to bend in order to make the best decisions. It is unlikely that I would ever compromise equality but then again I don't need to do so. Diverse companies outperform norms by significant margins. It just so happens that my strongest protected value works well with successful leadership. 

Protected Values

This week I am asked to examine three protected values that I hold and, in short, how far I am willing to go to protect those values.

Protected values are values that a person holds that they adhere to and not trade away for something else. Core values could be another term for them. No matter what they are called, they hold a special place for those that hold them. For me the biggest protected value I hold is equality followed by compassion, and finally courtesy. I am not so sure that I hold much else in the way of a protected value as a great deal of what I consider a value like honesty is often subjective. I usually shade the truth every day when working with patients in order to present things in the best light. I might not shade the truth in other areas of my life but the fact that I know that it is relative seems, to me, to be something that is less a protected value and more a highly admired value.

Equality is the value that I hold most dear. I believe that all men and women are equal in value and that what affects the least of us is a direct reflection on the behavior and attitudes of the best of us. I am by no means suggesting that a utopia of peace and harmony is attainable but I do think find discrimination based on things such as race, gender, sexual orientation, and age to be particularly heinous.  To be sure there are certain jobs, such as a concrete finisher, that I might not hire someone in their 80s for but otherwise I think we should all be judged on our merits. I do not trade this value for much of anything and in fact will go quite far to avoid people, and places of work, that do discriminate. I've lost friends over it and I've distanced myself from some family over it. I don't know that I can describe how much of a blight I feel discrimination is upon human development. With such a strong feeling towards the matter I don't know that I would compromise this value. I certainly don't support policies of discrimination even if I know I may receive a tax break from an elected politician which seemed an odd thing to worry about until this last election.

Along with that is compassion. Compassion for others takes many forms and I believe that when we approach the world with compassion we become better humans as a result. All of that being said, I do trade-off compassion when it comes to protecting one group of people for another. I don't have a great deal of compassion when I know a terror cell leader has been killed even though that leader most likely had a family and was most likely loved by someone or seen as a freedom fighter by others. That isn't to say that I don't have compassion. I don't feel joy in the death of others. I may feel a sense that something needed to be done that was unpleasant but I am smart enough to know that others that seek to harm me may feel the same way. Compassion is born from insight into others. I don't hate ISIS even if they are evil and cannot be allowed to continue. I hate the conditions that allow something like ISIS to form and there is a large distinction there.

Courtesy may seem like an odd thing to hold as protected value but I think it goes back to my view of humans as a species. There isn't much that separates us from higher primates and some creatures such as dolphins. Primates can use tools, they communicate, they have emotions, and they have a social structure. It is my opinion that the ability to temper our base emotions and behavior with courtesy and politeness are a defining feature of humanity, or rather should be. What some cultures view as rude, others view as not rude. For some things like dining habits this is mostly non-consequential but for how people approach fundamental interactions being rude can have real consequences. I don't deal in a great deal of moral relativism, just because a country's culture says women can't drive doesn't make it correct as I view anything that subjugates another to be morally indefensible. This isn't to set up a larger argument of moral relativism as that is a whole different argument and one that is covered in my blog from prior classes. However, it is related to courtesy in that on some level I believe that politeness should be universal even though some aspects of it change from culture to culture. I placed this value last even though I don't really trade politeness very often. That being said, there are times I've smiled and been polite while behind the scenes orchestrating less than polite outcomes when I have felt that I needed to defend myself.

Protected values are something that I tend to shy away from in the larger sense. Dealing in absolutes is not always a desirable trait in a leader. What I find to be more accurate is that a protected value is only so good as it is morally defensible. People can say segregation is bases on a value of one race being better than the other but can it be morally defended? Perhaps it can through twisted readings of religion or even bad science but if you have to pervert a teaching to make it fit your biases you've already lost the moral ground upon which you decided to stand.

Marshmallows and Kindergartners

The Marshmallow Challenge is an interesting leadership workshop exercise that highlights, to me, important concepts or preconceived notions and process facilitation. The challenge and a talk regarding it can be found here and Tom Wujec gives a really clear and concise overview of the subject. There are a series of questions that are posed regarding this talk and they are below:

1. Do you agree with Tom Wujec's analysis of why kindergartners perform better on the Spaghetti Challenge than MBA students?

I do to a certain extent. Wujec states that the kid prototype first and learn from their mistakes. He also states that kids are less concerned with leadership roles and finding out who is in charge of the group. They just get to the task at hand and go from there. I find that in my place of work we often do not concern ourselves with who is leading a group so much as we just focus on the task at hand. When we do start to get into who is leading a project it seems that less gets done as we get into a mode where we focused more on procedure and less on results. This is interesting for me as I tend to focus on procedure and how procedure impact effectiveness. The kindergartners don't have this problem... they just produce. 

I would like to add that the kindergartners don't have a pre-conceived notion of how something is supposed to operate. I think that as adults we have notion of how something is supposed to look and then try to make the process fit that vision (in this discussion vision refers to the final product and not the leadership trait of vision). We don't question if the vision was the best vision possible until the vision turns out to not work. Even then we don't often question the vision itself but how we got there in the first place.

2. Can you think of any other reasons why kids might perform better?

The lack of fear of failure may also have something to do with why the kids perform better. Kids are happy to playing with spaghetti and marshmallows and they aren't concerned with what happens if the tower falls. In the adult world there are consequences for things that fail but they aren't always as drastic as they seem as first. Elon Musk's SpaceX rocket exploded when a first landing was attempted and it is rather spectacular to watch but SpaceX didn't pack up shop and called it a day, they went back and they learned from it and nailed a subsequent landing. Failure didn't stop Musk from completing his project anymore than the kids were concerned if their towers fell over. To be sure an exploding rocket is an expensive failure but it didn't stop them from trying again. There is a lesson to be learned from accepting failure as a possibility. Personally I'd be leery of anyone that never failed at something...how much could they really be trying?

3. In your view, why do CEOs with an executive assistant perform better than a group of CEOs alone?

This comes down to facilitation. Assistants are trained to keep a process moving and to provide relevant information. Additionally, good CEOs know that their assistants know what they are doing and they learn to listen to them. A leader is only as good as the information he or she has and how well they process that information. We live in an information age and assistants make sense of that information and present it is easily digestible chunks. Additionally good assistants learn to work with personalities, they know how to manage people and keep them task focused. This adds a valuable dynamic to a group. 

4. If you were asked to facilitate a process intervention workshop, how could you relate the video to process intervention skills?

The process is almost as important as the result in my opinion. I think there is tendency to work backwards from where you want to be instead of seeing where your process takes you. Leadership is a bit more complex than stacking spaghetti but the underlying trust of process remains the same. If a process isn't getting the result you need maybe the result isn't where you need to be. Of course, the process could be also be faulty and both need to be examined but I would argue that the process is the more important of the two. Learn to trust failure as a teacher. It takes trail and error to get a process correct. However, if the process is good and the results are not what you wanted maybe take a look and see if the goal was realistic in the first place. 

5. What can you take away from this exercise to immediately use in your career?

Learn to trust the process. One of my weaknesses is that I do focus on the process and tend to tinker with it. Not every process is a good process but conversely not every process is a bad process. There is a tendency when focusing on change that we need to go in a change all sorts of things. The adage "if it ain't broke don't fix it" can still hold true. Determining which is which is the tricky part. 

Process and results are a type of symbiotic relationship, you can't have a result without a process and without a needed result you don't need a way of getting there. The two go hand in hand and as I tend to believe the process is the more important of the two that is where I focus my efforts. However, there is a danger in over-analyzing the process and neglecting if my desired results were realistic. The kids produced better towers because they didn't concern themselves with figuring out all the variables and assigning tasks, they just built the tower and learned from mistakes. This is pure process improvement and validates my stance that processes are important but I'd be willing to bet there was one person that wondered why we needed to put marshmallows on spaghetti in the first place. That person is handy to have around at times. 

Negotiations or Lying?

At some point we are going to enter into negotiations with someone else for some sort of purpose. Be that buying a car, a house, or even simply negotiating how to spend an evening with loved ones. Bill wants to watch a movie but Jill thinks Monopoly is tops and wants to do that instead, so they negotiate and decide to have a movie night a week and a game night a week. Much of life is a negotiation in that regard. 

However, many forms of negotiation can have serious consequences though even Jill may eventually leave the relationship if her desires are not respected. In the professional world negotiations can have serious effects and spotting disinformation or lies can be tricky. 

One of the main ways I sort information is by doing a fair bit of research ahead of time. I don't ask a question of a car salesman unless I already have the answer from several other sources. I want to evaluate his honesty. Additionally, I have a frame of reference regarding what a car is worth or what options it has. I also know ahead of time what practices a dealership may use to add fees or needless financing options. Research is invaluable in negotiations. From the sellers perspective, researching the buyers needs can also go a long way towards fruitful negotiations. 

I also evaluate the reputation of the other party. There are those that I work with as clients that are dishonest more than they are honest. Believe it or not, patients lie. They are also often poor historians of their own conditions. That being said, other patients have better track records of being honest. If a patient admits to drinking or using drugs it makes going forward with treatment planning much easier. This is the same for the other programs in which I interact, every program has its own needs which brings us to the third point.

Understand the other party's motivation. If you can figure out what they need you can tailor negotiations to meet those needs. In many cases other departments in my organization are short staffed so I am able to provide work-therapy options to patients in recovery by placing them in those departments to gain work experience. Where this gets complicated is when I sign contracts with agencies in the community and not in my organization. These contracts detail how a patient will work in the organization and how the organization will be billed for the services we provide. The outside agency gains inexpensive labor as we pay all the insurance but they are expected to train the worker and they will be billed. Additionally, our patients often have impairments so an agency may balk at the idea of training someone in recovery. 

These negotiations mean that I sometimes have to find a way to place the patient in the best light and gloss over some of their deficiencies. It is a fine line as I have a reputation to protect and if I consistently provide workers that steal from the employers, as has happened, I will find myself without placements for the patients. At the same time, the patients deserve the best chance to recover that I can provide even if they are they often their own worst enemies. 

Understanding how the other party thinks is also very helpful. I'm lucky in that regard as professionally we have a great deal of training in understanding how to read people. This allows me to, as the song says, "know when to hold 'em and know when to fold 'em." When you can develop an idea of how the other party thinks you can begin to see where they are deceptive and when they aren't. This isn't foolproof of course and as is less useful than what I have mentioned above but getting into someone's head allows to tailor a negotiation. Personally, I rely more on research than I do anything else but it never hurts to know your audience.