October 18, 2017

Thomas D. Johnson: Antifragile: How WC Organizations Can Benefit from ‘Disorder’

By Thomas D. Johnson, VP of Sales, Genex Services IME Division

Tom JohnsonVolatility, disorder, uncertainty, and randomness are conditions we dislike and try to avoid. However, in his 2012 blockbuster book, Antifragile: Things That Gain from Disorder, author Nassim Nicholas Taleb paints a different picture.

If something is fragile, it breaks easily. Think of a crystal goblet or Fabergé egg — neither would do well if dropped onto a concrete floor from any appreciable height.

But what is the opposite of fragile? Taleb argues we have no word for it. If fragile is “to be worse off when exposed to volatility,” the opposite implies that something must be “better off when exposed to volatility.”

In response to this epiphany, Taleb coined the term “antifragile.” Is this a real thing? Shockingly, when armed with this new perspective, we can see examples all around us. People go to the gym because they are better off after exposing their bodies to healthy stressors. Trees grow stronger when exposed to the wind. Babies become resistant to new viruses and bacteria with each new exposure. The list is endless.

Benefits for Workers’ Compensation
How can we apply this antifragile concept to benefit workers’ compensation (WC)? Referencing my background in the IME industry, we are inundated with volatility and variability on a regular basis. Each state is subject to their own statutes as well as federal regulations. Customers have different workflows or preferences. IME physicians have unique practice requirements, processes and fee structures. You get the picture.

But by harnessing the idea that we can be stronger through volatility, organizations can learn to be resilient, while establishing better standards and best practices for the future.

That sounds great, but how does one get there? The journey to become antifragile is exactly that: a journey. There is no final destination, only constant movement in adapting to change, navigating unexpected twists and learning lessons along the way.

Four Key Principles
By drawing on my experience in systems design, I’ve adapted four principles to establishing an antifragile organization. With each principle, I provide an example from the IME industry.

Observe and Interact
These might be the most important leadership attributes of effective organizations. Regardless of the technology an organization uses, it’s the people who really make a difference. Most companies possess a hidden treasure trove of energy, ideas and inspiration. If you want to measure your wealth, start by observing and interacting. Once you’ve sorted through and prioritized the diversity of ideas for improvements, it will lead to actions that have a greater positive impact for your organization.

The most sophisticated IME companies are comprised of individuals with a wide range of perspectives, experiences and professional backgrounds. By observing and interacting with these individuals throughout the organization and in different geographic regions, it is possible to deliver an IME offering that meets the regulatory requirements in each jurisdiction and the cultural expectations of IME physicians and customers in each local market.

Catch and Store Energy
Each day in the WC arena, countless claim decisions are made based on the knowledge and experience of industry professionals. To further leverage this asset, advanced companies have made significant investments in technologies that enable “know-how” to be captured, harnessed and, when appropriate, automated to facilitate accuracy and consistency while saving time and energy.

The IME industry is no exception, particularly when looking beyond regulations to preferences. No single person can grasp the nuances of every market, customer and physician. However, by providing local teams with best-in-class tools and systems to institute best practices and flexible workflows, those regional teams can adapt to local needs while maintaining rigorous standards.

Optimize the Edge
My favorite “business edge” is the line of interaction between a company and its customers. A lot can happen here, and by embracing and engaging in dialogue at every opportunity, relationships can develop and deepen. Even if you don’t talk with customers in your role, you have numerous edges to explore. Find and optimize them.

In the IME industry, customers come in many varieties: claims adjusters, managers, administrative specialists, attorneys, paralegals and executives. IME physicians, who technically might be considered vendors, are also important customers. Successful IME organizations live on this edge with frequent communication, two-way feedback and learning along the way. Some level of unpredictability is a fact of life on the edge, but that inherent volatility is invaluable as an adaptive tool.

Creatively Use and Respond to Change
In the WC industry, change is unavoidable. We face new regulations and jurisdictional requirements every year. This is where the four keys to antifragility coalesce. If you follow the first three keys, then you have a wealth of information and relationships to draw upon. You can then synthesize what has been learned and look at your organization or industry with powerful insights. This may lead you in a creative direction that helps resolve industry challenges.

For example, in the recent past, IMEs were ordered in a highly fragmented market, populated primarily by local and regional companies. Today, the industry has evolved with insurers trending away from using many IME vendors and toward establishing a preferred list of best-in-class IME companies with sophisticated information security, clinical coordination, quality processes, efficient workflows and advanced technology platforms. Volatility has enabled antifragile IME companies to emerge with the infrastructure and expertise to meet industry demands and offer added value.

In closing, Taleb has illuminated a concept that has not been discussed in our industry despite its prevalence. If leaders within organizations can employ the four principles above, they can unlock further potential and opportunity, and begin a journey toward becoming antifragile in their own right.

About Thomas D. Johnson
Thomas D. Johnson is Vice President of Sales for Genex Services’ Independent Medical Examination (IME) division. With a B.S. in mechanical engineering and an MBA from the University of Oxford, Mr. Johnson has worked in various IME senior leadership roles for over 14 years.

Based near Raleigh, NC, he has practiced system design throughout his personal and professional life, including the IME arena. An occasional public speaker and writer, Tom draws upon his diverse experiences to find antifragility in all walks of life.

About Genex Services, LLC
Genex LS LogoGenex Services is the trusted provider of managed care services enabling workers’ compensation payers and risk managers to transform their bottom lines. Genex is a managed care leader with more than 2,900 employees and 47 service locations throughout North America. The company serves 381 of the Fortune 500 companies as well as the top workers’ compensation and disability carriers and third-party administrators in the U.S. In addition, Genex is the only company that delivers high-quality clinical services enhanced by intelligent systems and 360-degree data analysis. The company consistently drives superior results related to medical, wage loss, and productivity costs associated with claims in the workers’ compensation, disability, automobile, and health care systems.

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