why physicians and administrators
regularly have communication clashes.
Physicians are highly trained experts
at finding a unifying diagnosis i.e.
the crux of the problem; the thing
likely to go wrong. We see clinical
issues that administrators are
completely unaware of and we do
this at lightening speed, because our
diagnoses must often be made quickly.
are not used to having to explain
ourselves. And we shoot from the hip
we see it and call it without regard
for the social setting or the politically
correct thing to say in the given
situation. One word for this
is `blurting'.
about a program with a group of
administrators. They do not think or
communicate in this fashion. It is not
what you say, but how you are saying
it. Disruptive-physician labeling can
often be the result of this clash of
communication styles.
PHYSICIAN'S TOOLKIT
to avoid labeling and ensure your
survival within the workplace.
When you know you are going into a
meeting with administrators and have
a concern, talk to as many people as
possible before the meeting. To raise a
concern for the first time in the midst
of a meeting is the definition of rude
to an administrator. Discovery and
building of consensus is best done
like the work in politics is done in
conversations before voting takes
place. You want your concern to be
discussed, shared and understood, and
you at least want a partial consensus
on what to do about it well in advance
of any committee meeting.
Rather than making statements, ask
questions of everyone involved in the
proposal, and everyone who will be
part of the decision on whether or
not it goes forward. Always start your
questions with the words `what' or
`how'. This guarantees an open-ended
question that will draw the maximum
information from the person you are
speaking to.
· "What are your thoughts on
able to address them?"
Do your best to imitate the character
of Columbo in the old TV series.
With hand to the forehead, be self-
deprecating by saying something
along the lines of: "Maybe this is a silly
question, but I was wondering..."
wrong and never in doubt, and I
encourage you to let that go. Columbo
was never called disruptive and was
always very effective in his dealings.
If, during your pre-meeting
discussions, you find your concern
is shared by your colleagues, build
ideas to address your concerns. This
way you will have support on the
concern and the possible solutions in
your back pocket before the meeting
even begins.
Always keep the team focused on the
highest possible corporate value one
that everyone typically agrees with.
This will usually be quality of care or
patient satisfaction. When you are
bringing up any clinical concern about
an administration proposal, relate it to
one of these higher values whenever you
can and this will be your trump card.
agree that none of us wants the
quality of care to suffer as a result of
this initiative..."
the big picture, and not your objection.
It states something no-one can
disagree with and keeps people from
immediately disagreeing with you.
agreed with, there are things you must
avoid doing.
Do not raise your concern the way you
would normally do on automatic pilot
as a declarative statement of fact.
For example: "I think this is a bad idea,
and here's why..."
Columbo by appearing to be either
curious or confused.
initiative is supposed to make it easier