I Love To Tell the Story
For those aspiring to be leaders in medicine or even have some influence over the operations of your clinic, you will have to know more than when to increase someone’s insulin. You will need to tell the story.
A hallmark of a good leader is the ability to express a narrative. A leader will not just tell his people what to do, he will tell them why they are doing it and the broader context behind why they are doing it. And if he’s really good, then he will do it in the context of a narrative that inspires and points to a noble mission.
Preventing the Turtle Response
This skill is especially important for a leader looking to introduce change. Physicians, in particular, can be a very tough audience to change. Given the current dynamic environment in healthcare, many physicians have taken to turtle mentalities where they retreat into their shell and resist any change that comes their way, no matter what the potential benefit to them is.
A competent physician leader will be able to coax their staff out of their shells and explain how change benefits them and the organization as a whole. Connecting change to the greater purpose and direction of the organization will give you the best chance of eliciting buy-in for the change you are trying to implement.
I have too often seen leaders elicit directives to physicians with minimal effort to tell the relevant story around why a decision was made. These “edicts” are always met with resentment, and in the absence of any narrative, physicians will fill in their own narrative that often assumes the worst intentions.
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The Angry Colleague
I can recall a particular example where it was necessary to change several physicians’ clinic grids. The clinic’s wait time for new patients had grown too long, and these particular physicians had not been seeing new patients recently. The situation was especially challenging because these were senior physicians in the group that had effectively pushed the responsibility to see new patients disproportionately onto the younger physicians in the group.
I made the mistake of sending an email with my decision first and then following up in person a day later (rookie move). By the time I was face to face with them 24 hours later, they had officially declared World War III. In their mind, I had switched from their colleague to a worthless bean counter with no regard for the many years of hard work they had put in.
As I sat down, the most senior physician opened the conversation by angrily demanding why they were seeing new patients when the younger physicians needed to fill up their panels. He then started to rapid fire questions at me. Are the younger physicians lazy? Do we need to find better junior colleagues? It was not going well.
After he finished speaking, I paused for a moment to collect my thoughts and then asked a single question of him.
“Why have you worked so hard for so many years at this clinic?”
He was taken aback at this, but after a moment he answered.
“I became a physician to help my patients and community almost thirty years ago, and I expect others here to do the same.”
“Perfect, I said. I agree. Now, how are we going to achieve our common goal of helping the patients in our community if we can’t even get them in to be seen?”
There was much conversation that followed, but ultimately, the senior colleagues agreed to the schedule change. It could not have been done by forcing it on them and walking away. Tapping into our common mission and common narrative around that mission was the only way they would agree to get on board. If you are looking to lead in any realm at your clinic or hospital, then you can’t afford to do any less.