Originally posted on BSCI21.org (http://www.bsci21.org/to-profit-or-not-to-profit-that-is-the-ethical-question-five-ways-your-aba-company-will-profit-by-behaving-ethically/)
Adam Ventura, M.S., BCBA
bSci21 Contributing Writer
Running a business in Applied Behavior Analysis (ABA) can be a challenging endeavor, and those who try and fail can end up feeling like their story is one of Shakespearian tragedy. If we want to achieve and maintain profitability, “we must give us pause” and consider ethical organizational behavior. From working with clients with special needs to dealing with insurance companies and payroll, operating an ABA business can be tough. Adding to the myriad of other responsibilities an ABA business owner has, worrying about ethics often tops the list. It almost feels like the word “ethics” has obtained some kind of conditioned aversive status, doesn’t it? Just hearing the word can evoke heart palpitation, sweating, and an overall feeling of dread.
It’s time we changed that. Ethics can mean more than just trepidation and stress—they can also mean increased profit and less worry. It sounds strange, doesn’t it? In behavior analysis, the word “profit” tends to have a bad connotation of its own, because in the past people have engaged in a lot of unethical behavior in order to obtain more profit. But ethical behavior and turning a profit can work hand in hand if you do things right. I recently re-read one of the best books on organizational ethics and behavior analysis I have ever come across, A Good Day’s Work. In the book, the authors discussed payoffs from ethical organizational actions and separated them into positive and negative reinforcement. Below is an ABA version of those benefits:
Positive Reinforcement: The gold standard of ABA intervention also provides some benefits in the event your organization behaves ethically.
- Good reputation: “Whether ’tis nobler in the mind to suffer the slings and arrows of outrageous fortune” (Hamlet): Reputation matters in behavior analysis. Since we work in such a small field and we all know each other, developing and maintaining a good reputation is paramount to developing and maintaining relationships. Most behavior analysts don’t want to be associated with people or companies that behave unethically. In ABA therapy, patients will often refer their friends to a specific company because it provides good service—this means more business and ideally more profit.
- HELPFUL HINT: Become a thought leader who specializes in organizational ethics. This will help build your individual and company brand in the ethical arena. Not sure what a thought leader is? Check out Manny Rodriguez’s article on bSci21 here.
- Recruitment & Retention: “There is more work in ABA than there is workers” (Ventura, 2016). In the field of ABA, the competition isn’t for clients; it’s for the certified professionals who work with those clients. Recruiting the most highly trained behavior analysts is always easier when you can show that your company prioritizes ethics. The more analysts you hire, the more clients you can serve and the larger your profit margin will eventually become.
- HELPFUL HINT: When recruiting behavior analysts, as part of the interview process, ask the interviewee about their ethical code. This is a good way to show the prospective employee that ethics matter to you and to weed out candidates who may do something inappropriate during their tenure at your company.
- Morale & a Friendly Environment: “Tis a consummation Devoutly to be wished”. Although employee morale is largely subjective and hard to measure, there will probably be more smiling faces in the office and fewer resignations if the staff are engaging in behavior they know is ethical.
- HELPFUL HINT: Add ethical measures to performance evaluations and scorecards in order to help build a culture of ethics.
Negative reinforcement: Not as ideal as positive reinforcement, but we all know what they say: “You are always trying to get something or get out of something.” In this case, we are focusing on the “get out of something.” Engaging in ethical organizational behavior is negatively reinforced by avoiding aversive social contingencies.
- Bad PR: “Take arms against a sea of troubles”. Just like behaving ethically provides you with good publicity (positive reinforcement), it also keeps you out of trouble by avoiding being branded a “shady” company and earning yourself (and your company) some unwanted public attention. We’ve all heard of those companies that have developed a bad reputation for fraudulent billing, inappropriate use of punishment techniques, or shady hiring practices. Don’t be that company; keep your ethical behavior above-ground. If you do, more people will want to work for you and more clients will want to procure services from your company. And you guessed it—that means more profit.
- HELPFUL HINT: Address any ethical issues that come up transparently. Often, it isn’t the crime that does you in, but the cover-up.
- Legal Problems: “The undiscovered country, from whose bourn no traveler returns” (Hamlet). Behavior analysts tend to be a rule-governed bunch—i.e., we follow instructions as closely as possible. And although there are multiple reasons for this, the one that stands out is getting into trouble with the law. Running an ABA business means that you will be held accountable to a variety of different regulatory bodies, from insurance companies to COEBO. The body that can really ruin you, though, is the government. There are a variety of different laws intertwined with the provision of ABA services. One such set of laws surrounds medical billing and can be a big problem for your company, as you may end up having to repay funding sources through audits and recoupment processes, which could signal the end of your business. Behavior analysts are rarely provided with appropriate training in this area, and if they aren’t careful, they can end up breaking a variety of different fraud and abuse laws, including (Office of Inspector General: Fraud & Abuse Laws):
- False Claims Act
- Anti-Kickback Statute
- Exclusion Statute
- HELPFUL HINT: Before starting your business, get to know the laws and regulations for the area you provide services in and the funding sources you work with.
If you are an ABA business-owner or want to be one someday, take heed of “the enterprises of great pitch and moment” and ensure your organization behaves ethically. If you do, profits are in ye future.
Office of Inspector General (n.d.). A roadmap for new physicians: Fraud and abuse laws. Retrieved November 5, 2016, from https://www.oig.hhs.gov/compliance/physician-education/01laws.asp
Rodriguez, M. (2015). How thought leadership can advance the dissemination of ABA. Retrieved November 05, 2016 from http://www.bsci21.org/how-thought-leadership-can-advance-the-dissemination-of-aba/
Lattal, A. D., & Clark, R. W. (2007). A good day’s work: Sustaining ethical behavior and business success. New York: McGraw-Hill.