Put Donald Trump in charge of Walter Reed

Blog readers: This place is still about business, the slight edge and all the stuff you expect from me. Still, I thought you might find this interesting or instructive (or amusing, who knows), since my comments to the big guy are in the same context as I would normally write here on any other day. I faxed this to the White House today, and thought Id share it with you guys in hopes that you will find it useful.

Dear President Bush,

I write a business blog called “Business is Personal” at http://www.rescuemarketing.com/blog/. The blog is about small business, entrepreneurship, customer service, marketing and similar topics of interest to the entrepreneur. I do what those inside the Beltway spend some of their time trying to do – I help small businesses become more successful.

I thought I would comment on the Walter Reed situation – in an entrepreneurial context. Anyone who has paid attention knows that there have been problems of one kind or another at Walter Reed since the 1960’s, if not longer. Since Bill Gates was in front of the Senate today to talk about labor, visas and hi-tech, I thought I would carry my little piece of the load and apply a little entrepreneurial logic to this round of problems at Walter Reed.

Again, my comments here are written on what an entrepreneur would do if put in charge of Walter Reed. Yes, I fully realize that the Army, like government, is no place for an entrepreneur and an entrepreneur has no place in the Army – with the possible exception of Lt. Gen Honore of Katrina fame, but ignoring “having no place” and the status quo is part and parcel of being successful in small business.

The problems discussed in this article are the kinds of things that get fixed in an entrepreneur-managed organization without a second thought. As such, I thought I’d share a few thoughts along that line. My entrepreneur for the sake of this discussion is Donald Trump, but the fact is that any real entrepreneur would do.

#1 – I see that you and Pentagon chief Gates have assembled a blue ribbon commission to investigate the problems at Walter Reed.

An entrepreneur does not assemble a commission. An entrepreneur issues instructions and things happen.
There’s an anecdote about Donald Trump finding a puddle on the floor of one of his NYC hotel rest rooms. Trump finds a maintenance supervisor and says, “I want this cleaned up immediately, I’ll be back in 10 minutes.” 10 minutes later, Trump finds that it still hasn’t been taken care of, finds the maintenance supervisor, asks why it isn’t cleaned up, gets a lame excuse in response and as a result, fires the guy on the spot. He then turns to the other maintenance guy standing there, tells him he’s the new maintenance supervisor and says “I’ll be back in 10 minutes.” The message is clear. Fix it in 9.5 minutes or you are fired as well.

Why the hard case approach? Trump understands that one of his multi-million dollar gamblers could walk into that restroom, fall, sue him, or worse, become angry and leave the casino without dropping a million at the blackjack table. He understands the value of details. The slight edge. Action.

Action NOW, that is. Not committees to investigate the problems and report back FORTY FIVE DAYS later, but I’m coming back in 10 minutes and if it isn’t fixed, you’ll be fired.

Ever read the book Broken Windows, Broken Business? Might be worthwhile. While the mouse droppings etc might seem like something perfect for the media to pick at, the real story is that these things – as repulsive as they are – are indications of larger systemic problems (the kind the rest of this article talks about). This sort of thing is apparent to the entrepreneur, who notices trash on the floor when they walk into someone else’s business, the same trash that the staff has been walking around all day. The difference? The entrepreneur picks it up and tosses it in the trash can – and its not even their business. Fix it now.

For the rest of this post, assume that I’m taking Trump’s role here and speaking for him. In reality, this is my speculation at how he would handle it.

Meeting #1 with the staff, held at the end of the next 3 shifts: In the room – doctors, nurses, aides, EVERYONE, even the janitorial staff:
Walter Reed has some problems. I am here to help you cure those problems and turn this into an operation that takes care of our wounded as they deserve. We will not be concerned about politics. We will not be concerned about covering someone’s butt or pointing a finger. Our only concern is for the soldiers and their families. Taking appropriate and prompt action, and being responsible for every soldier placed in our case is our ONLY responsibility. I will deal with everything else.
Ok, let’s go. 2 forms were handed to you when you entered the room. A transfer form and a resignation form. You have a decision to make. Transfer, resign, or become a part of the turnaround team. If you are filling out a form, leave the room immediately. Those are the only 3 choices. Do it now. You have 1 minute.
If you are not willing to work under these conditions, you may transfer or resign.

If you choose to transfer, your request will be approved and you will not return to Walter Reed. There is a clerk in the room at the end of the hall who has a list of critical openings and a few laptops that can be used to search for other Army opportunities.
If you choose to resign, I thank you for your service. The clerk in the hall has your payment records on her laptop. She will write you a check for 4 weeks severance pay before you leave. It will be your responsibility to follow up with the Army personnel division regarding pension and other issues. Do not argue with the clerk in the hall. Take your check and move along.
1 minute later: Is everyone here because they want to be part of our turnaround team? If not, get out immediately (pause briefly).
Ok, here’s the deal. I will deal with the politicians. I will deal with the Pentagon. I will deal with the press. YOU will take care of our patients and their families. You will care for them as if they are your favorite relative or best friend. That is the standard of care. We are their family and they are here because of sacrifices they made while serving their country. Do what needs to be done. No one should need to tell you to pick up a dead cockroach, pound a rat over the head with a mop handle, paint a wall, or throw out a nasty rotten mattress. Just do it.

If the press or other visitors are here, it is because they have my permission. Do your jobs. It is not their job to distract you from your duties, nor to change how you do them. As of this moment, we have nothing to be ashamed of and no one to hide from. You will keep it that way.
Got a problem? Find a supervisor. Supervisor got a problem? Find me if you can’t fix it now. Most things you should be able to take care of. Make a decision with the care of the patient as your decision point and you’ll be good with me.

Grab a yellow pad on the way out the door. If you see something that you would fix in your own home, but you don’t have the tools, materials or skills to do so, write it down and place it in the work boxes you’ll find throughout the complex. Supervisors, I expect those boxes to be emptied every 2 hours and the work completed within 24 hours. If the work is done to your satisfaction, toss the paperwork on my clerk’s desk and sign it that you and the person who requested it have accepted the work as completed properly. If I see shoddy work that you have signed off on, you are fired. If you need help figuring out if a job is done right, ask someone for help and get them to sign along with you once you are both happy with the work.
We will meet again in 3 days. I expect results, not excuses. Thank you for stepping up and taking this honorable duty. Let’s get to work.
These 3 people at the front of the room will produce a “cookbook” of sorts over the next 3 days. That cookbook will tell our patients and their families what their country will do for them during and after their stay here. At the end of that 3 days, 100 temp nurses will arrive. Over the next 3 days, they will spend 10 minutes with every patient we have in our care. Each nurse has an assistant. They will examine each patient, explain the cookbook, hand it out and send a copy to the soldier’s home address along with my office’s phone number to call for questions. Every soldier will get a map of the area. If they have trouble understanding the map, we will assign an aide to them. That aide will be with the soldier during all 3 mealtimes – at a minimum. If a soldier needs something, get it. If we’re out, fix it. My office has people ready to solve problems and is available by phone or via your handheld. Let them know your patient needs help of any kind.

My casino staff has implemented a simple security system. This security system is in place for the safety of our patients, their family and our staff. Press has full access to the building, but they must check in at the security entrance like any other visitor. We cannot have strangers roaming the facility and still maintain a safe environment for our patients and their families. The press are not at your beck and call. They will do their work, you will do yours. Your patients are your only concern. Your work will tell our story to the press. I will talk to the press, as necessary.
We have staff in place to contact every soldier or their family who has been here for the last year. I want to know they are ok and are not in need of our assistance. This contact will be complete within 30 days.

Once this process is complete, a non-medical staffer will have personal contact with every patient a minimum of every 14 days until they leave Walter Reed.

Our patients are no longer in charge of other patients. They need to concentrate on healing and getting back to their unit, their next assignment, or their family. We have added 100 case workers. Our case workers will check in with their patients on a weekly basis. All of these things are monitored by our patient tracking system.
I have hired the former ombudsman of the New York Times (since they dont seem to like having him around) to act as the ombudsman for our patients and their families. His job is to fix problems. During the initial 30 day “see all patients” process, our staff will make sure our patients and their families understand what the ombudsman’s job is and how to contact him. He has direct access to me. He will act as the public’s watchdog, just in case we miss something. He has a multi-lingual assistant. He also has an experienced staff that brings years of disability benefit management experience to help our patients apply for and understand their disability benefits.
A volunteer management staff has been put in place to help us accept and manage the gifts for our soldiers. They report to my office on a weekly basis. They have been put in touch with volunteers from a local SCORE chapter, who will help us manage and distribute these gifts.

Every soldier who has an upcoming appointment will be notified by a postcard and a phone call. Appointments for any soldiers who have trouble getting to the appointments OR remembering them will be assisted by a staff member, who will accompany them to their appointment. We will assess this ability during the visits that occur in the next 3 days. A staffer will also pick them up, take them back to their quarters and contact their family with the appointment results.
A uniform has been issued to every soldier who was able and willing to wear one. Everyone else has been issued appropriate gear depending on their condition.

I have spoken with the CEOs of Expedia, Travelocity and Hotels.com. Their staff will make travel arrangements for all families, at our standard advance rates, billed to Walter Reed. An account at all 3 sites has been setup for the donation of frequent flier miles. The CEOs of Delta and American Airlines have committed developing a transportation plan for the long term, including free standby seating to any US destination and free upgrades to first class when available. We will not waste any time frustrating families with things like the inability to make change. In 2007, handing out cash and dealing with expense reports is simply not necessary. Our inability to predict outpatient discharge dates is not a patient problem. Its our problem. Patients and their families will not be penalized because we cant do our jobs effectively. We will improve at these tasks and we will do so rapidly.

There will be no more morning formation until further notice. Anyone who has a question about that is invited to speak with the Secretary of the Army, as I have.

Food will be carried in on a daily basis, on premises. Soldiers who are willing and able to make the trip to the canteen are welcome to do so. Anyone who wants or needs to eat here at 18 can do so.
3 different national pest control companies have visited the building this week, they have agreed to knock out the unwanted visitors within the week. Some patients may have to be temporarily moved to a different room while their room is being treated. They have committed to a monthly follow up for the next 6 months, with quarterly follow ups thereafter. Likewise, the nations’ 3 largest mold remediation firms have assessed our mold problems and in conjunction with Trump Construction and Home Depot – promise me that these areas are 72 hours from completion.
Overhead Door Corporation has replaced the broken garage door with a secure model. I have contacted the local police and made our needs clear. Their cooperation has been outstanding, and includes a commitment to 24 hour patrols of our facility, 7 days a week. The locals have been warned that this is not a place to mess with. I have backup security squads on site. They are well aware of their duty and responsibility. My message to those who would threaten our patients and their families is simple: It’ll be your last mistake.

The CEO of Brunswick tells me that they will have the rec room fully equipped before the end of the week. Rotary, Lions, and Kiwanis clubs in the area have committed to having volunteers in the rec room several days each week. The Psych department staffer who held up the previously mentioned funds out of fear of retribution has been reassigned to another duty.
I have scheduled a monthly meeting with the major Veterans service organizations. I have asked for their experience and leadership. They will oversee our performance, gather feedback and act as my eyes and ears.

Finally, you might be wondering how we’ll pay for all of this. We’ll spend what’s in the current budget. We’ll cut costs where we can. In addition, I’ve made some corporate contacts who have made indeterminate pledges of support, to be delivered as we need it until we can formalize an official corporate support program. I have the IRS chief and the ranking members of the House and Senate on board and as of this morning, they have promised tax relief for this support. In the meantime, our corporate contacts have pledged support regardless of tax relief. So far, a total of $37 million in annual pledges has been made by these contacts, with more coming in every hour. In addition, I have arranged for a new PGA pro-am tournament to be held at Congressional here in DC, with 100% of the proceeds, merchandise and tv revenue going to Walter Reed, including arrangements to fund an endowment that will provide a substantial portion of the revenue necessary to make this successful.

15 thoughts on “Put Donald Trump in charge of Walter Reed”

  1. If yoy think that you can hire 100 nurses in a day and put them to work the same day at Walter Reed, you know nothing about the civilian job market for health care works, nothing about joint commission (the accrediting body for healthcare facilities) or about the type of neighborhood.

    You live in a fantasy land where you can make things work if you get to ignore the constraits that all organizations and especially military healthcare functions under.

  2. SuperD,

    Same day, yeah, probably not. 72 hours? I have no doubt that *substantial* progress would be made toward those numbers.

    There are nursing pool organizations all over the planet that are in business for exactly these reasons, and that’s just one example of the available resources. While nurses in some areas are in extreme demand, that isnt the case everywhere.

    FYI, my wife is a RN. She has worked in downtown Dallas, and downtown Little Rock, among other places. I have spent more than my fair share in and around those workplaces. I grew up in the DC area, and no, not with a silver spoon. Im well aware of what DC area neighborhoods are like.

    One thing to keep in mind: these almighty governing bodies are the ones that implicitly “approve” the CURRENT situation. If the leadership in our government had any cojones, they would be doing something about THAT deadwood.

    Entrepreneurs make things happen because they dont put up NOR allow themselves to be constrained by the fake barriers that bureaucracy builds. Certainly, there will be some eggs broken when these toes are stepped on. On the other hand, if they were doing their jobs, we wouldnt be having this discussion.

    Thanks for jumping in.

  3. One of the differences between an “entrepreneur” usually avoids situations where he does not have ownership. The government, by definition, is an organization where no one own much of the process.

    At Walter Reed, Buildling 18, that has been in the media, is controlled by a different organization than the one that provides the medical care. The medical care is managed by Medical Command. The guest houses (since Building 18 is not really a barracks) is managed by the Installation Management Command. In addition, the physcial Evaluation Board, the organization that caused the backup of personnel, is owned by the Army Deputy chief of Staff-Personnel( The G1 in Army jargon).

    Also, Congress has passed numerous laws saying that government officials cannot spend money that they do not have. Thus, to hire 100 nurses or 100 caseworkers means that the Walter Reed commander would have to cut funds.

    To put things in prespective, Walter Reed does not have insurance (the government self insures). thus if a building has water damage or an electrical fire destroys the 2 million dollar MRI system, there will be no additional funds to fix the damage. It comes out of current operating funds.

    Also, the cusotmers at Walter Reed are differnt that the customers of Donald Trump. If I do not like a Trump property, I can take my business else where. The patients at Walter Reed do not have that option.

  4. No doubt there are numerous obstacles in place here. Likewise, the customers in other businesses have better choices, in fact, better because they HAVE a choice, however none of these problems appear to be customer-caused.

    Remember, I said that my comments were in the context of “what an entrepreneur would do at WR”, not “17 bureaucratic obstacles to making anything positive happen in DC” (17 is about 2 orders of magnitude too low, in general, IMO).

    Outside of that little box, I suspect there is a combination of problems going on there that are partly management and/or bureaucracy caused, some funding, and some personnel related. The latter are the ones that the current staff cannot blame on anyone else and the ones most easily addressed by the right people and the right leadership.

    Owning the process is what everyone there should be taking steps toward.

  5. You should also understand that a commander for any large organization has little say in personnel. They are mostly there when he arrives and most will be there when he leaves. They know this and thus can take a “wait it out” attitude.

    Unlike other parts of the Army, the Walter Reed Commander does not get to really decide who his colonel’s are. He also is limited in firing them because firing them could cause medical specialities to be unavaiable and to cause medical residency programs to lose their accreditation.

    Managing healthcare is slightly different than running a hotel or a condominium (the Donald Trump examples).

  6. SuperD,

    I understand all of that. Ive dug into this far more than Ive let on, and have other background on these situations that I wont bore you with. All of that is immaterial.

    Why? Because my post was a hypothetical response to a real issue. The question is “how would an entrepreneur react?”, not “What are the 417 reasons why entrepreneurial methods that Trump might use wont work at Walter Reed?”

    The post’s real intent is to illustrate the differences and the challenges between WR reality and how entrepreneurs work, achieve, and manage.

    The public comments of the General’s subordinates bear this out, but that was not germane to the lesson that this post was trying to provoke. We’ve all heard the so-called 5 steps of a crisis, including the escape of the guilty and the punishment of the innocent.

    Going back to my differences and challenges comment:

    The Army works in no small part because of its management structure. That model works particularly well in the situations it is designed for. In other situations (say, the chaos and unpredictability of a recon), its apparent that a different model, such as that used by the Marines, is more appropriate.

    In other cases, there are models that work better than either the Army or Marine model – including other mission specific ones that they use.

    Likewise, in a business, there are clearly differences in the management structures and styles that work best in different situations. Consider a startup vs massive growth period vs a turnaround vs a business “on cruise control”.

    Trump would not be the right guy (using my stated context) for the cruise control situation. For a turnaround, he’d be ideal.

    In the stated context, of course:)

  7. If you want to look at Walter Reed as a management failures, I would say that it represents the problem of concentrating on the new, differnt, emerging while relegating the normal daily operations to subordinates.

    The military as an “up or out” organizations encourages a culture of concentrating on high profile “projects” and discourages managers spending their time on day to day “operations.

    A lesson to Entrepreneur would be to spend as much time ensuring that the existing customers get a quality product instead of spending all of their time developing the next hot idea.

  8. Actually, I wasnt looking at it as a failure. Certainly there have been some mistakes, but to say that WR is a failure is to toss out the baby with the bathwater. Failures are instances, not people or organizations, in my mind.

    Back on the subject…I choose things out of day to day happenings in the news (or that happen to me) and use them to illustrate a lesson or a takeaway for entrepreneurs and small business owners.

    As you note, paying attention to existing clients and what you are delivering to them is absolutely what all entrepreneurs should be doing. It just happens to be #2 on my “7 steps to finding hidden profits” white paper (at EzineArticles.com and on my email newsletter).

  9. I’d like to comment on something “Superdestroyer” stated earlier — One of the differences between an â??entrepreneurâ? usually avoids situations where he does not have ownership. The government, by definition, is an organization where no one own much of the process.

    A lack of ‘ownership’ or not assuming responsibility for their actions or inactions is what’s appears to be lacking at WR and elsewhere throughout government. Those that have the responsibilty to manage “our” affairs should to be EXPECTED to do their jobs and to expect to suffer consequences for any failures and/or lack of action. Doing or saying otherwise is a cop out not to mention illegal and just enables those without a sense of accountability to continue their irresponsible ways.
    My father was a civil service employee at LRAFB in Jacksonville, AR. On board from the base’s inception, he helped to acquire land for the base, inspected ALL buildings on the base on a regular basis, as well as inspected the Titan missile silos throughtout north central Arkansas. It was his office’s (containing both civil service and AF personnel) responsibility to ensure that the base’s infrastructure was well maintained and accounted for. He and his colleagues took their responsibilities seriously for not doing so could get someone hurt or killed, especially in regard to the missile silos.
    Mark’s point of ownership is a valid one. If more people in ‘our’ governments would behave in such a manner countless things would improve. Comments and expectations to the contrary are not helpful, just enabling.

  10. URBuddy,

    One of the most underreported problems is the absolute slow pace that people were being evaluated by the Army’s Physicial Evaluation Board. The process was taking months and years. Yet, the Physical Evaluation Process was not part of Walter Reed Army Medical Center but belong to the Army Deputy Chief of Staff for Personnel. Yet, the inefficiency of the evaluation board board caused the avaialble soldiers quarters at Walter Reed to exceed capacity.

    I believe that most entrepeneurs would avoid a situation where they do not control the throughput of their business. Yet, the Walter Reed Army Medical Center commander does not get to determne who is customers are or when they stop being his customers. That is a very different world than where Donald Trump lives.

  11. Superdestroyer,

    True, but the fact remains that the civil servants and military personnel responsible for maintaining WR did not have to allow such disrepair to occur. Whether it is called “taking ownership”, taking pride in one’s work, or just plain doing one’s job the results should be the same. Not taking responsibilty, ownership et al is why the new Secretary of Defense relieved a few people of their duties. A person can not excuse their actions and blame the higher ups for their troubles just as one can’t blame the makers of the kevlar vests and other body armor for for an increase in the number of soldiers surviving their injuries and needing treatment instead of burial.

    Passing the buck solves no problems rather it serves only to cause problems. Rolling up one’s sleeves and getting to work does the opposite.

  12. URBuddy,

    Here is a perfect example of what you are talking about.

    A government worker who cant pick his clients, cant change the rules, and is potentially in a great position to have a bad attitude and just do what it takes to get through the day.

    Instead, he kicks some butt and proves that anyone, even a government employee with no control over much of anything, can make great things happen.

    http://www.arcamax.com/businesssuccess/s-172233-196439-print

    URL may wrap, so keep that in mind.

  13. Wow, what a great article!! I really like your followup comment:

    “Entrepreneurs make things happen because they dont put up with NOR allow themselves to be constrained by the fake barriers that bureaucracy builds.”

    Gosh that is so true. ‘course, the double-edge sword it is, fake barriers DO give you an excuse when you want to drop the ball. Think about it….successful entrepreneurs NEVER give themselves permission to indulge in that.

    Data points, Barbara

    Barbara Ling, Virtual Coachs last blog post..Embracing Kettlebells (you know you want to!)

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