The Killing of UnitedHealthcare CEO Brian Thompson: What About The Employees?
Immediately following the murder of UnitedHealthcare CEO Brian Thompson on December 4, 2024, the media was filled with stories of senior executives beefing up security details and removing their names and photos from company websites as a way of ‘circling the wagons’ in hopes of preventing a similar incident. Yet little was mentioned, then or since, about the impact this incident would and will continue to have on UHC employees. Mr. Thompson’s death, combined with a constellation of unprecedented and concurrent factors makes this a multilayered shock trauma workplace event for employees of UnitedHealthcare and UnitedHealth Group.
Here’s why and important things to consider.
Intersection of Grief and Trauma-The Double Whammy of Traumatic Loss
By all accounts, Mr. Thompson was well-liked amongst those within UHC and by his peers in the industry. The shocking manner of his death creates a challenging intersection of grief and trauma requiring a far longer runway for coping and managing than most understand or that corporate eco-systems typically have patience for.
Not surprisingly, ‘experts’ began posting shortly after Thompson’s death claiming a “return to normalcy for most employees within 2-4 weeks”. These expectations are myopic and worrying, based on a generalized understanding of acute stress response expression following a traumatic incident. It’s misaligned with the realities of grief from a traumatic loss combined with several other compounding factors for employees, discussed below.
Grief and bereavement literature (Worden, J. W. 2009; Sanders, C. 1988) citing risk factors that increase coping difficulties indicate: the higher the degree of perceived preventability of a death when combined with other determinants including unexpectedness, a ‘stigmatized’ cause, a young(er) decedent, and involuntary secondary losses, significantly boosts the likelihood of coping challenges in the short and long-term. Thompson’s death meets this criterion for those impacted by his loss and not just for those who were personally close to him. People can feel deeply the prominent death of someone they know little or not at all. Consider the response to Princess Diana’s tragic demise and other celebrity deaths.
Every shock trauma event in the workplace is unique and creates permanent change. Ask anyone who has survived a workplace active shooting incident, experienced a death by suicide that occurred at their job location or a high-profile scandal plastering their company front and center in the media. They will tell you that their perspective of the world, their job, themselves, professional priorities, and their employer shifted, in one way or another. There is nothing ‘general’ about shock trauma events, each requiring responses that speak specifically to the circumstances of that incident and influenced by what happened before the event.
Reactivation of Previous Lived Violent Experiences for Employees
As of September 5, 2024, one day following the Apalachee High School shooting in Winder, Georgia, there were 11,598 deaths in the U.S. from gun violence, averaging 47 a day. Sadly, Thompson’s death in December added to those grim statistics. And these numbers don’t include those injured and burdened with medical outcomes that are disruptive and often ruinous financially, professionally, and personally. The irony for victims of gun violence who may currently be fighting with their insurer to receive the care they need is almost too much to bear. And denials for care aren’t just limited to health insurers. Workers Compensation carriers, notably from the San Bernardino shooting in 2016, are known for doing the same.
What gun violence death statistics don’t illustrate is the number of people impacted by each one of those deaths. People who are grieving and trying to ‘do life’, struggling with the absence of a parent, loved one or friend and the meaning they brought to their lives that is now gone.
Those who work in disaster planning to establish Family Assistance/Reunification Centers within hours of a mass fatality use a calculation of 8-10 people per decedent to approximate the number of people they’ll be serving. During the first year of the pandemic social science researchers Verdery et all, 2020, used the same formula to begin understanding the bereavement impact of that mass fatality event.
Do the math. This means that as of Sept. 5, 2023, approximately 115,980 people were grieving and directly impacted by gun violence. Many of those people have jobs or go to school where they are expected to focus and complete tasks on deadline whilst managing the invisible wounds and emotional fallout of what’s happened that endures far longer than what western culture recognizes and gracefully accepts. And these numbers only reflect up to September 2024. There are cohorts from previous years still struggling with outcomes from gun violence and other violent deaths. Those who survived the Edmond Oklahoma post office mass shooting in 1986, from which the term ‘going postal’ emerged, have in subsequent years relayed in interviews how long the impact from that event was present in their lives both professionally and personally. For many who emerge from experiencing a violent loss the impact is permanent.
There are approximately 400,000 employees working under the UHG umbrella, parent company of UnitedHealthcare and Optum. Undoubtedly, there are employees who have already been touched by gun violence or some other form of violent death. It’s probable that Thompson’s murder could trigger a reactivation of that lived experience, making the current incident all the more disruptive and challenging to cope with- one of those complicating factors I referenced earlier.
Scandal and Public Vitriol
High profile scandal and public shaming are also drivers of shock trauma that affect organizations. Employees of UHC and UHG have been experiencing this in the extreme since Thompson’s death.
Reports indicate that Thompson was under a DOJ investigation for alleged insider trading at the time of his death and had been arrested for DUI in 2017. As liked as he was, this information might not align well with the image many had of him. We have a cultural standard of not speaking ill of the dead and post-mortem revelations suggesting questionable behavior around honesty, fidelity and trust can be confusing and provoke intense feelings of betrayal by the decedent, contradictory to customary mourning.
This past summer UnitedHealth Group CEO Andrew Witty was publicly excoriated by members of Congress for having insufficient protections in place following a massive ransomware cyberattack that made vulnerable sensitive personal data for an estimated one third of Americans. With the considerable resources available to UHG (the largest healthcare company in the world by revenue) for ensuring such protections, this creates reputational risk for employees compounded by perceived preventability by the public, only furthering an image of corporate greed at the expense of enrollees. This, in addition to several high-profile lawsuits UHC and UHG are currently defending against.
UnitedHealthcare clocks in at having the largest number of claim denials. The avalanche of vitriol, public shaming and mind-numbing frustration expressed in the wake of Thompson’s death from patients, families and physicians relaying heartbreaking stories of care denials for pain relief during end stage cancer and last-hope lifesaving treatment, allegedly to boost company profits, has been excruciating for UHG, their brand and the insurance industry as a whole.
In ill-advised videos intended for employees only but subsequently leaked to the media, Witty, clearly feeling pressured, engaged in a bit of a rant defending UHC policies for ensuring the provision of ‘necessary care’ and went on to marry that defense with company sustainability. Not helpful. That this was allegedly leaked to the public by an insider may suggest a whistleblowing effort to contradict Witty’s statements.
Immediately, Social media was littered with jokes using Thompson’s death to parody insurer denials for lack of prior authorization, relegating Thompson as a less than sympathetic victim to many, some going so far as to suggest his death was justifiable. Horrifying to hear for those mourning his absence and a violation of customary western cultural norms for how we respond to death and talk about the dead in public, making even smaller the circles where employees might feel safe to speak openly.
For those at UHC and UHG sincerely believing their work to be serving the public good, this may be their first confrontation with the full measure of consequences for enrollees, following their employer’s denial decisions and alleged business practices, of which their own work contributes to.
For others, especially those serving as ‘grievance coordinators’ at UHC, whose job is to engage directly with enrollees fighting claim denials and whose authority to effectuate desperately needed relief is quite limited-whilst previously able to compartmentalize the suffering they’re chronically exposed to, their ability or desire to carry on in that role, in the face of what may be considered overwhelming ‘evidence’ of what their work is supporting, may no longer be possible for them.
The above examples create a perfect environment for the development of ‘Moral Distress’ amongst employees, defined within the research as the psychological impact from confrontation with a situation that violates one’s ethical standards and code of conduct but feeling constrained to speak up, change, or prevent due to fear of harm, loss or threat.
Moral Distress is a form of trauma resulting in intense shame, guilt, rage, anxiety, depression, self-loathing, a loss of self-respect and self-confidence (Epstein, E.G., Delgado, S., 2010; Fourie, C. 2010)) that can be professionally and personally debilitating. For those employees who may have already been experiencing moral distress, Thompson’s death and what it has unleashed may be the final straw, activating an intense emotional reckoning for them.
Death Threats and Fears for Personal Safety
Whilst it’s not unusual for senior executives in myriad industries to receive death threats, since the shooting of Thompson, threats and safety concerns have significantly escalated and not just for executives.
Leaders of other insurers have cautioned employees from wearing apparel or using objects displaying the company name or logo out of an abundance of caution. Think about the impact that has on employees coupled with the outspoken ‘moral equivalence arguments’ on social media that Thompson’s death was justified. Andrew Witty has confirmed receiving “you’re next” threats. This creates a chilling environment for employees, raising the prospect of more violence to come.
It would not be unreasonable for those employed by health insurers to experience concerns about their own personal safety and begin to wonder if their job is worth that. Going to and from work looking over one’s shoulder can be emotionally taxing and terrifying for employees and their loved ones. Any loved one of those serving in law enforcement or the military could give you a master class on that.
Uncertainty, Anxiety, & Layoffs-Secondary Losses
In addition to all the above employees are currently facing, there naturally exists uncertainty regarding Thompson’s replacement and what they will or won’t do in the way of change that could be quite disruptive and unwelcome. It’s likely the selection of Thompson’s permanent replacement will take time-enough for employees to ‘stew’ in uncertainty.
New senior leaders often bring in their own people for their executive team. Will there be layoffs at the top and structural changes triggering redundancies down the ranks? For those who enjoyed reporting directly to Thompson, inevitably there’s anxiety about what life will be like under new leadership and new reporting relationships, common even under normal changes from retirement or succession. White collar jobs have been especially hard hit in the U.S. over the last couple of years. For those in leadership positions close but not at retirement age, the prospect of suddenly being made redundant and forced to find new employment at this juncture of their professional career and financial responsibilities can be frightening and destabilizing.
With the ocean of negative criticism targeting UHC will enrollees jump ship especially during periods of open enrollment? Will layoffs be used to manage financial hits not just from loss of enrollees but also from the legal cases still looming that may not go their way? The timing and cascading impact of Thompson’s death couldn’t be worse.
Unhelpful Notions Around ‘Return’ and ‘Normalcy’ Following Shock Trauma Workplace Events
By now, you probably have a better understanding of how ill-conceived the earlier referenced expectations are for a ‘return to normalcy within 2-4 weeks’ considering the layers of complexity within this shock trauma event that has rocked the world of employees and will continue reverberating for some time.
Since the pandemic, Western culture has talked non-stop about ‘resilience’ and ‘bouncing back’, constantly seeking hacks for doing it faster. Common language for resilience frequently uses ‘return to normal’ phrasing and is something business leaders often say they’re anxiously awaiting and trying desperately to achieve, as soon as possible.
That’s their first mistake in the long road to unwinding the impact and recovering from shock trauma incidences.
For UHC, their previous ‘normal’ didn’t include the experience or even the conscious possibility of the CEO being deliberately shot and killed in broad daylight, made worse by the deliberate connection to the company’s very reason for existence. Thompson’s death was neither random nor bad luck from being in the wrong place at the wrong time. Literally, the unthinkable has happened. So, a return to that time, space and a type of innocence that was their ‘normal’, is impossible. Life, as they knew before, is over. Even Witty, during one of his leaked videos to employees stated “we will never be the same.”
What’s necessary in the wake of shock trauma workplace events is fashioning a new definition and experience of ‘normal’ that incorporates what has happened, rather than attempting to recreate what was. This will ‘take a village’ of all who inhabit that organizational eco-system.
Final Note: What Employees Need From Leadership in the Wake Of The Unthinkable
Shock Trauma frequently hijacks safety, functioning, and a sense of purpose. The goals employees and managers discussed before the event often just don’t matter now or perhaps never will again. Priorities and meaning-making often change following significant disruption and loss. Restoration from these types of events will neither be influenced nor dictated by impatience, the calendar, or Wall Street expectations.
Employees are desperate for leaders to lead, not just manage, in the wake of workplace trauma.
I invite those in leadership positions to consider incorporating the following in the wake of a critical incident:
Tap into self-awareness and humility to engage in reflection and a personal inventory to identify how this incident has impacted you; actively seek support to address that impact and model those behaviors for others. In doing so, you’re giving permission for them to do the same.
Reestablish psychological safety throughout the organization and address trust gaps.
Ask people what they need rather than assume resulting in ‘fixes’ that aren’t helpful. By asking you’re acknowledging that you see and hear them, whilst communicating humility that you don’t have all the answers but will do what’s necessary to find out.
Set realistic expectations in concert with the realities of how trauma and grief impacts human beings and align your operational decisions accordingly in the short and long term.
Understand that getting back to a fully functioning place will be evolutionary, rather than magically reappearing from the pressure of external dictates.
Provide multi-formatted ‘pro-active’ support mechanisms (educational events and coaching) extending well beyond initial on-site grief counselors or emergency responses by your EAP in the early days following the event. ‘Pro-active support’- bringing free help and resources on-site for easy access v ‘passive support’- depending on employees to seek it for themselves through provided phone numbers and websites.
Provide trauma and grief informed training and support for all in management positions to be better equipped for communicating and working with affected employees and teams.
Develop crisis communication skills.
Provide mechanisms for anonymous communication with management to de-risk the sharing of feedback and information, removing fear of real or perceived retaliation.
Connect with your people and help them to connect with each other to identify and work on what matters now, because of what happened, not as if it didn’t.
This critical work requires expertise for integrating trauma and grief informed practices with effective leadership skills and pitch perfect communication. Often, shock trauma workplace events are first time experiences for leaders so understandably there’s a deep learning curve.
If you as a leader, managing in the wake of a shock trauma incident don’t have this expertise, your most important job now is to find and work with those who do.
It could be a career and legacy killer for you if you don’t.