Three Simple Questions To Help You Manage Disruptive Employee Behavior

Guest post by Brenda S. Campbell

One of the most challenging aspects of practice management is managing the people within the business. It can feel overwhelming to manage employee attitude, behavior and performance, especially if confrontation doesn’t come naturally.

Screen Shot 2016-06-05 at 9.56.40 AMI have had the privilege of working for an amazing pediatrician for the last fifteen years. He’s been in practice for decades and has taught me so much about practice management, especially the “people” part.

He has helped me understand that it is possible to manage any employee behavior and expectations using a simple strategy.

When confronted with unsatisfactory employee behavior and performance, it is important to focus on three questions:

You send a message to the rest of the staff no matter how you handle the issue.

What’s the message you want to send?

If you choose to overlook the behavior, the message to your staff is that it is okay to continue this behavior and that it is acceptable.

If you address a behavior, it sends a message to everyone that the behavior is NOT okay and will not be tolerated. Often times, even though they may not say it, the staff appreciate that you address negative behavior.

For example, we had a telephone triage nurse who had a lot of experience, worked for us for several years and was solid in the advice she would give.

Her customer service skills, however, were lacking. I had to make a decision about the message I wanted to send to the rest of the staff.

What you allow is what will continue. Are you going to allow it to continue?

Make the decision to address the behavior and do it. Don’t put it off. Ask, “May I give you some feedback?” Let them know the problem with their behavior, set expectations and move on. They’ll either choose to correct their behavior or they won’t.

We’ve found that employees generally receive feedback in one of two ways. Some are completely unaware that their behavior was being perceived in a negative manner and are quick to ask how they can fix it.

The others become defensive and refuse to take ownership of the behavior often blaming external factors.

With our triage nurse, I knew that I needed to address her customer service problem, particularly her tone which could be perceived as condescending and snarky at times.

Her response fell in the defensive category and she said “somehow I get all the nasty parents on the phone.” I explained to her that she was the common denominator in each complaint and that her tone was the problem.

“Ma’am” is not necessarily respectful if delivered in a sarcastic manner. It was her behavior that made the parents become, in her eyes, “nasty”.

Are you better off with them or without them? Is it time to let them go?

If, after you’ve given the feedback and they have not changed their behavior, it’s time to make the decision about the employee’s future.

As you may have guessed, it didn’t take long for another parent to complain about the triage nurse and, at that point, we decided that even though we’d be down a phone triage nurse in a busy sick season, it wasn’t worth allowing negative behavior to continue thereby sending the wrong message to the staff.

We have found that when it comes to working with someone who behaves poorly or working short-staffed most employees would rather work a little harder until we find someone who is a good fit for our practice.

It’s certainly easier in the short term to ignore problematic employee behavior but it’s always costly in the end.

Allowing negative employee behavior to continue can hurt your employee morale, productivity and retention as well as cause you to lose patients. When we reflect on the occasions where we’ve had to let someone go after asking these three questions, we have yet to regret a single one.


Brenda Campbell is a practice administrator for The Pediatric Center at Frederick. You can check out her practice by clicking, here. She is a member of AAP’s subcommittee Pediatric Practice Management Alliance (PPMA). This article originally appeared in SOAPM’s Quarterly Newsletter.


 

How Well Do Parents Know What You Do As a Pediatrician?

It’s hard to appreciate the value that pediatricians provide when one is not aware of exactly what it is that pediatricians do.

During the summer months, I posted on our practice’s Facebook page, a note encouraging parents, to schedule their children’s wellness visits.

Although the message was for our entire Facebook community, I wanted to catch the eye of parents with teenagers. Don’t know how well you manage teens in your office, but in our office, we have decent wellness visit numbers with younger patients. The teen population?

Not so much. Once the teen years kick in, we mostly see them when they are sick.Screen Shot 2016-02-26 at 11.48.51 AM

I wanted to encourage parents to make their wellness visits but also throw in a subtle nudge to parents with teens.To get their attention, I opened with this line: Did you know pediatricians are trained to treat children from birth to adolescence? Then I went on to talk about the importance of wellness visits etc.

Something interesting happened. The post outperformed other Facebook post. It received more likes that than the ordinary. But that the surprise me. What surprised me the most, were the comments from parents.

One mom said, “it’s good to know the pediatrician can see my teen.”

Another said, ” Timothy is going to be so happy when I tell him Dr. B can still see him.”

WHAT WAS THE LESSON?

It’s an age-old lesson. It’s a lesson on assumptions and what happens when we make them.

That simple, otherwise ordinary status update, got me thinking about how well (or not) we communicate what it is that we do as pediatricians. If so many people weren’t aware that pediatricians can treat teens and beyond (0-21), what else don’t they know? The irony is that our website is tagged with the line “Pediatric & Adolescent Medicine.”

OPPORTUNITY

We clearly have a communication problem. And I would argue that our lack of proper communication about what it is we do as pediatricians (more than runny noses and giving shots) is why many parents don’t see the distinction between a retail clinic and a pediatrician.


 

It’s hard to appreciate the value that pediatricians provide when one is not aware of exactly what it is that pediatricians do.

 


 

The good news is that there is a significant opportunity for pediatricians to cover a lot of ground. How so? By using social media channels to educate our community about all the great services we are trained to provide.

I also believe that leveraging this opportunity could aid your practice in differentiating itself from the competition.

WHAT IS YOUR COMMUNICATION STRATEGY?

Since I realized there was a chasm between our assumptions and the reality, I’ve been intentional about informing our community about the training, knowledge and expertise our pediatricians can address.

Some of it may seem too obvious for those of us that do this every day. Like explaining the importance of wellness visits.

But the truth is, some parents don’t know about yearly wellness visits. They assume that because the child no longer needs shots, they don’t need to go to the doctor.

Beyond promoting wellness visits, I use many of the things included in the Bright Futures guidelines as a way to highlight that a visit to the pediatricians is highly comprehensive.

And by educating our population, I’m also marketing our practice in a unique way. Instead of mentioning in a promotional piece that we accept most insurance plans, I may mention that how we can provide family support, safety and injury prevention, or mental health.

MARKETING STRATEGY

Not only is promoting and sharing this information relevant and valuable to parents, but I also think it is an excellent way to differentiate ourselves from the MinuteClinics or other medical services that overlap with pediatrics (i.e. Urgent Centers, Family Practice, Telemedicine).

YOUR CHALLENGE

Think about your medical practice’s communication strategy, or lack thereof. What is your practices unique selling proposition? What problems do you solve that others don’t? Then think about how best to communicate your message. Also, consider the channels you’ll be delivering your message. By channels I mean, traditional advertising, email campaigns, social media, etc.

Remember, each channel is unique, thus requires you to craft the message differently.

I’ll leave you with this… times are changing. That is certain. And we have two options, two paths to choose from. Disagree with how things are changing, or find ways to agree with the shifts in a way that benefits you and your practice.

4 Simple Questions That Will Make You A Better Manager To Your Employees

As practice managers and administrators of both large and small practices, we are wired not to see our failures but instead see the shortfall of our employees and attempt to correct them. Nothing wrong with that. It’s part of management.

But let me challenge you on this one. The next time you have difficulties with an employee, take a moment and reflect how you are interpreting the issue using the questions above. Consider where you are placing the blame. On people’s character or the circumstances?

As humans, we have an uncanny ability to justify and explain situations in ways that benefit us.  For example…

When we observe a father shouting, tugging or being overpowering towards their child, we raise an eyebrow and pass judgement on that parent’s poor parenting skills.

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If we lose our temper with our kids, we justify it by blaming the circumstances. We’ll say, “if you knew how challenging my children are, you would understand.”

In a medical practice environment, it may go something like this.

Julie: Nancy is late again.
Michelle: That’s the way she is. She’s so disorganized.
Julie: I know. And she doesn’t take her job seriously.
Michelle: Bill has given her so many opportunities, but she seems not to get the message in that thick head of hers.

Let’s look at it from another viewpoint.

Julie: I’m sorry I’m late. It’s just that my car has been acting up. And with my husband being out of town, I have to get the 3-kids ready, drop them off at my mother-in-law’s house – you know she is still upset about that thing – and just as my luck will have it, there was a fender bender on Route 95 and traffic was backed up all the way to the freeway.

CHARACTER VS CIRCUMSTANCES

Medical practice managers and administrators tend to make similar judgements.

When we have an under-performing staff member, we question their work ethic, make claims about their lack of motivation, engagement or lack of interest. Simply put, we tend to judge their character.

When we fall short, we don’t dare blame our work ethic, lack of motivation or lack of interest. Instead we blame the circumstances.

For example, we’ll blame our underperforming employees, unreasonable parents, the healthcare system, insurance companies, the printer, the network, being overworked and our boss. She’s too demanding and has unrealistic expectations.

REVERSE

What if we reverse the tendency to blame circumstances when we fall short and blame people’s character faults when they make a mistake or underperform? What would it look like if you looked at your character when employees in your practice fall short?

To help you put all of this into perspective, think about a time in the practice when an employee was underperforming. Using that situation in mind, read and think about the four questions I’ve listed below.

1.- Am I measuring a fish by its ability to walk?

Everybody has their strengths, but if you place someone in an environment that is counter to their strengths, they will undoubtedly fail.

Before rushing to judgement, ask this question first. Have I done a disservice to the employee by placing them in a position that they are not naturally good at doing?

2.- Am I telling them instead of leading them?

The best leaders are not the best because of their title. The best leaders are remarkable because they have distinctive character traits. Thus, asking employees to think and see the way you think and see things is often unfair.

Instead of saying, why can’t they just… (they being employees) ask, have I led them?

Consider putting more efforts towards helping them understand – leading them – rather than expecting them to know.

3. – Am I assuming employees remember?

Just because you said it once, doesn’t mean it was heard or retained.

If an employee keeps overlooking necessary task for example, take pause and consider if the reason is that you have not made clear the importance of the tasks.

One important distinction to have present when reminding employees. It is more important to tell employees why their jobs matter than remind them how to do their jobs.

4. – What am I doing about it?

Some hires simply are not a good fit. Others don’t work out. You know that. The entire staff also knows that.

Keeping an employee around that doesn’t fit well into the culture, is disruptive, consistently underperforms, and makes mistakes despite coaching, is a failure of leadership.

In other words, an employee that is out of line is not necessarily your fault, but it is on you if they remain an employee of the practice.

As practice managers and administrators of both large and small practices, we are wired not to see our failures but instead see the shortfall of our employees and attempt to correct them. Nothing wrong with that. It’s part of management.

But let me challenge you on this one. The next time you have difficulties with an employee, take a moment and reflect how you are interpreting the issue using the questions above. Consider where you are placing the blame. On people’s character or the circumstances?

 

Simple Yet Effective Leadership Lesson You Must Learn If You Are A Practice Administrator

Medical practices don’t sell products, transport goods, develop software or produce widgets in a factory. Our businesses are all about people. Consequently, the only way to improve productivity or enhance performance is by getting better at managing people.

Screen Shot 2015-08-30 at 2.01.20 PM

One day, his wife complained that in their 25 years of marriage, he had never told her that he loved her.

“I told you when we got married. I’ll let you know if it changes,” he replied.

Acknowledging staff members or affirming employees for a job well done doesn’t come naturally to me. I’m the kind of person that believes recognition isn’t necessary when someone does as expected.

YOU’RE SUPPOSED TO WORK HARD

For example, I’ve heard employees say, I worked hard for this company. This comment doesn’t deserve affirmation.

Why? Because the expectations is not to barely do mediocre average work. The expectation is that people work hard. Pronouncing you work hard is like a father publicly declaring he takes care of his kids.

WHEN IS TOO MUCH, TOO MUCH?

I also feel that if you praise a person for their good job often, the praise eventually loses value. Like the word thanks. It’s polite, but is one thankful every time we say thanks? So when I acknowledge someone’s behavior, character, work ethic, etc. it is because it truly exceeded expectation.

WHAT IS THAT ABOUT?

Here is the thing. As a member of the team (as opposed to the boss) I like to receive positive feedback. I like to get recognition, have someone acknowledge my work and accomplishments.

WE ALL NEED TO HEAR IT

I’m sure the wife in the story knew the husband loved her, but she needed to hear it from him. And just like the wife, people too need to hear from the person in charge words of appreciation even though they heard it once before.

The affirmation, praise, recognition, pat on the back (how ever you want to describe it) isn’t only for those in charge to give to their reports. This also applies to colleagues and peers.

Furthermore, I’d challenge those of you that have bosses, supervisors or managers to share words of encouragement as well. They need it just as much as you need it too.

HAS BRANDON GONE SOFT?

You may be wondering what this has to do with practice management, business, revenue, CPT codes or ICD10? A lot!

Medical practices don’t sell products, transport goods, develop software or produce widgets in a factory. Our businesses are all about people. Consequently, the only way to improve productivity or enhance performance is by getting better at managing people. And frequent reminders that show appreciation is one of the best way to become a great practice manager.

As it turns out, people that are recognized, appreciated and affirmed are far more productive, far more efficient, and far more happy than those that are not.

 


Do you regularly provide positive feedback to your employees? Do you provide positive feedback to your boss, manager or supervisor? If so, how do you prefer to affirm or show appreciation to the staff? A note by email, a handwritten note, publicly? I’d love to hear ways your practice engages employee.


 

10 Questions You Need To Ask Before Starting A Project To Ensure Success

The best strategy one can embrace before beginning a project is to gain clarity on the task at hand. And with these 10-questions, you’ll gain the perspective required to ensure your project gets off to the right start.

Imagine all of the sudden you decide to go on a camping trip. So you round up your spouse and the kids, jump in the car and head out. No supplies, no route, camping equipment, site, food or proper clothes. When asked about all these things, you respond by saying, “We’ll figure it out as we go along.”

I’m no camping expert, but I know that this is a silly way to go about camping. Talk about a recipe for disaster.

Screen Shot 2015-08-30 at 4.17.50 PMBut here is the thing… even though most people would never go on a camping trip without determining a site beforehand, planning out the best route, deciding how much food they’ll we need to take and how many days they will stay, I’ve seen first-hand many practices that have embarked on more than one project with the same carelessness.

“What is the plan for the transition?” 

“Too busy right now. We’ll figure it out as we go.” 

I’m no project management expert, but that is a silly way to about conducting a project at one’s practice. No wonder many projects end up taking longer, are more expensive and cause more headaches than expected.

To get a better understanding of the project, we should ask ourselves these questions:

1 – What is the project?

It is important to write down the project because writing it down actually means something. If you have it in your head, you don’t really have a project. You just have an idea.

2 – When is it due?

The more specific, the better.

3 – Who is responsible for this project to succeed?

You can add all the team members, but ultimately, there has to be somebody that is THE responsible person.
Who is your customer?

4 – List the names of people that you are trying to please.

It could be your boss, your patients, your parents, voters, the board of directors or anybody else. It is important to list them because there is a good chance that you might lose sight of why you are doing this project. And when you do, it is helpful to know who you are doing this project for.

5 – Who are the authorities, influencers and gatekeepers?

List all those names under this question. These are the people that actually matter. Everybody else, you can ignore.

6 – Who is essential to the success of your project?

In every project, there are always key people that must embrace the project for it to succeed. List the individuals or committees or groups of people.

7 – What does perfect look like?

Often times, we start out a project without really thinking about what the end results is supposed to look like. Consequently, we lose direction. For this question, it is important to be as specific as possible.

8 – What does failure look like?

Failure is an important aspect of project that one must consider. For starters, failure is almost a sure thing. Thus, understanding what it looks like helps one steer away from it.

9 – How would you plus it?

Here is the stuff you put down when one says, “you know what would be cool?” List 5 or 10 things that would make your project that much better.

10 – How would you minus it?

Just like adding little things to make your project a little better, there are other things that you ought to consider that don’t add anything to the project. These are the things that if you take away from your project, you will actually improve it.

The best strategy one can embrace before beginning a project is to gain clarity on the task at hand. And with these 10-questions, you’ll gain the perspective required to ensure your project gets off to the right start.

Can A Mechanic Shop Teach Us Anything About Managing A Pediatric Practice?

I was reminded that to keep Salud Pediatrics focused, on task, an aligned towards our objectives, it is my responsibility to remind, affirm, correct and make adjustments (sometimes this process includes “changing” old worn out parts for new ones that perform better) to ensure the practice performs at its best.

I took my car in for alignment the other day. As I was waiting for the car, I thought about why the car needed alignment in the first place. If the car’s tires were aligned once, why the need for realignment?

My guess is that the car gets misaligned when something happens to it. For example, the car is jolted by a pot hole. I guessed road conditions, weather, vibrations or simply usage tend to mis-align a vehicle as well.

Screen Shot 2014-07-10 at 11.23.21 AM

Regardless of the reason, one thing is for sure; alignment brings a lot of value. Not only does it keep the car from veering off, but it’s also a preventive measure (kind of like a wellness visas). If you don’t care of your car’s alignment, the misalignment can create bigger problems in the future.

You know what else needs alignment?

You and the employees of your practice.

Why?

For the same reasons your car needs alignment.

There are things that cause us to veer off the path. Just like a car, your practice may have been jolted by an event. When this happens, we start to pull a little left. We tend to forget, lose focus or start heading down a path we weren’t intending on going down.

The jolt may have been a big change or a transition that occurred in the practice. But it could have also been subtle, barely noticeable. Anything from an important team member leaving the practice, to opening a new location to hiring a new provider.

Perhaps it was none of those things, but time.

That day at the mechanic shop I said to myself, just because I’ve aligned the staff towards our objectives, our purpose, our goal once, doesn’t mean that the alignment remains. 

I was reminded that to keep Salud Pediatrics focused, on task, an aligned towards our objectives, it is my responsibility to remind, affirm, correct and make adjustments (sometimes this process includes “changing” old worn out parts for new ones that perform better) to ensure the practice performs at its best.

And sometimes, that alignment begins with me.

What needs to be aligned?

I don’t know what those things are for your practice, but for me, areas in which we need to be frequently aligned are: our practice mission and core values.

I always go back to the core values and our mission because in it, I find reminders on why Salud Pediatrics exist in the first place; what’s are purpose as a practice; why do we come to work; who are we there for?

Once those things are in perspective, I know what needs to be done.

What about you?

What are the areas in your practice that need to be realign? Where have you or your staff veered off? Is the  practice pulling to one side more than it should? Has it been a while since you “aligned” the practice?

If so, it may be time to bring it in to the mechanic shop.


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Does Your Practice Management Toolbox Have This Essential Tool?

One day a staffer asked if me I could buy envelopes that have windows on them to send our, we seemed to have missed your payment letter. You know the kind that display the address from inside the envelop.

“What’s wrong with the ones we have?” I asked. “Nothing. It’s just that there are a lot of them and handwriting the addresses on the envelopes we have is time-consuming.”

“Why do we have so many delinquent letters going out?” I digged. “We have more people who haven’t paid their balances,” she replied. I followed up, “Why is that?” “I guess we haven’t been collecting all the copayment and past due balance when patients check in.”

“OK,” I said, “but why haven’t we been collecting…” “It has been hard to keep up… we’ve been really busy and we are short-staffed in the front desk” she answered.

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As it turned out, the envelopes with the windows wasn’t a great solution – merely a band-aid at best – because it wasn’t addressing the underlying problem.

The Power of Why

It wasn’t until the employee mentioned the staffing issue that I realized what had happened. I was a reminder of how powerful asking why was.

Had I said yes to buying the envelopes they wanted without first understanding the issue behind the problem, I would have not un-covered the source of the problem; which was a staffing issue.

I was also reminded that success in resolving an issue doesn’t always depend on the solution itself, but instead lies with our ability to frame the problem correctly.

And for me, asking a why line of questioning ( I’ve heard people say that asking why 7-times is the sweet spot), is a practical  and efficient way to frame problems correctly.

Give it a try

Next time you encounter a problem in your office, whether it is as simple as my envelope story or something potentially more complex, such as a drop in the number of newborns for example, begin by asking why before offering solutions.

Then, ask why again, and again, and again to each response.

With each why, you’ll take a step closer to find the core problem. And once you have a clear understanding of the problem, you will be on the right path to find the best solution and not merely a band-aid.

 


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Here Is Why You Can’t Afford To Miss The Next Practice Management Seminar

Last weekend I had the privilege to present at the Pediatric Management Institute (PMI) seminar in Oakland, CA. It was the first time presenting at a PMI event. Paul Vanchiere and his team put together a great seminar.OAK.001Not only were the topics informative and relevant, but the speakers did an awesome job of presenting the material in practical ways. Dr. Richard Tuck, such as, presented on various coding topics including ICD-10. Tough assignment. But he made it work.Dr. Nelson Branco gave attendees a look a different emerging pediatric models, Chip Hart walked us through the process of setting up a practice’s fee schedule, Sumita Saxena from the Verden Group gave us a lot to think about with regards to potential legal pitfalls in areas like human resources and PMI’s very own Paul Vanchiere covered a couple of topics, one of which was budgeting.Best of all? Seeing 65+ doctors, office and practice managers eager and enthusiastic to learn, explore, discuss and share ideas. As I caught up with old friends and met new one, it was clear that times are indeed challenging. But in spite of all the different issues independent practices are confronted with (e.g. hospital consolidations, large networks getting larger, acquisition, managed care, rise in hospital employed physicians), one thing was for certain; nobody in attendance was there to defend the status quo.

OAK.002I heard a lot of great stories. From a young physician that decided to open up her own solo practice so that she can, among other things, practice pediatrics on her own terms, to the group of practices in Chicago that decided to band together to form a super group to leverage the administrative synergies that come from working under one entity. These are just two examples of many.

There was one bad thing about the seminar that I can’t keep to myself. And that is, there weren’t enough pediatricians (and their staff) in attendance.

I think a seminar as rich as the one PMI put together ought to have been attended by thousands of pediatricians.

Why? Because the need for pediatricians and their staff to learn how to manage their practices better or as I like to called it, learn the business of pediatric, is more important than ever before.

OAK.003It goes without saying that just because your business is a medical practice you won’t be affected by the same market dynamics that other business have. But unlike other businesses, the stakes are higher for pediatricians.

Why? Because our customers (parents and patients) are depending on us to succeed. Otherwise, who is going to give the personalized, here-we-know-your-name type of care they’ve grown accustomed to?

The truth is it will be difficult to succeed staying on cruise control. The status quo is almost never a great long-term strategy.

If I got a chance to talk to you during the conference, I want to thank you for the inspiration. You’ve renewed my enthusiasm .

OAK.005And for those of you that could have made it but decided not to, I really hope you commit to attend a practice management seminar this year (at the very least, a coding and billing seminar). Your staff, your partners, your patients and the community you serve will be glad you did, even though some of them will never know it.

Until then.

What A Top Management Guru Can Teach Us About Managing Our Medical Practice Better

Jim Collins affirms that accumulated progress is what drives greatness in companies. He adds that focusing and being disciplined about progress in small increments is the only way to become a great organization. Greatness, in other words, is not a silver bullet. It is a work in progress. And we get there not mile-by-mile, but rather inch-by-inch.

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We often talk about making things better. We often challenge the staff to think about how to improve a process; for example the check-in or check-out or improving the process of drawing up the vaccines.

When we challenge the staff to find ways to make it better, faster, stronger, more efficient, we don’t imply incremental changes. We are, in essence, asking for an overhaul. We are asking for a re-invented, transformational, innovating change.

But Collins tells us that high performing companies don’t work like that. Great companies are disciplined in their progress, which in turn, results in incremental improvements; which over time creates drastic change.

For me, this is important. It reminds me that when challenging staff to improve, I need to be clear about not asking for a complete overhaul or make a request to dismantle a process, but rather emphasize that the purpose is to make incremental improvements.

This frame of mind also helps me set my expectations too. I often devise plans with the expectation to improve an area of the practice and make it 10x better. When in fact, small additions an increases accumulate over time are not only a more realistic approach, but it is also easier to manage.

How about you? How do you approach changes in your practice? When you and your team are trying to make changes, improve or make progress with something in the office, you expect a complete overhaul? When you come back from a seminar, do you want to implement everything you learned at once but end up not doing most of it because it was just too much?

If so, perhaps adopting this notion may help.

How Do You Get People To Change In Your Medical Practice?

When I speak at seminars and conferences, I often get asked questions surrounding the topic of change. Here are a few examples or variations of the questions:

  1. How do I convince my partners to change their minds about social media?
  2. All the partners agree that we need to change, but the senior partner doesn’t want to. How do the rest of us convince her otherwise?
  3. I’m a recent grad and I just started working at a practice that has been around for a long time. The owner and the staff are pretty set in their ways. I want to change lots of things, but I get push back when I make suggestions. How do I get the owner and the staff to see that they need to change?

RiseI usually respond by saying “…. there is a magic potion down in Baton Rouge called: Comment puis-je changer l’esprit des gens. Pour the potion into the drink of the person you want to change and wait a couple of weeks. They’ll eventually come around.”

I’m kidding… I don’t say that (out loud).

The truth is, I don’t have a clear cut answer. So I do what gurus do when they don’t know answers to questions.

And that is, I answer the question with a another question so they can figure it out for themselves. Brilliant! I know.

Here is how I usually respond:

Let’s say I’m a pediatrician that is having a hard time convincing parents to vaccinate their child. I’ve already brought up the issue during each wellness visit and discussed it at length with them, but the family won’t budge. So I come to you for advice. What would you suggest is the best way to change the parent’s minds?

This usually gets me off the hook. But I don’t re-framce the question back at them so I can get off the hook. The purpose is to get the person to realize the answer is complicated and can’t be solved with a one-size fits all approach. Moreover, it prompts the person to begin drawing from personal experiences and their knowledge of the situation (i.e. personalities, office politics, employee dynamic, partner relationships, etc) to find the best approach.

For some, it will take a year long trust building relationship before they are ready to hear what you have to say. For others, research, graphs, numbers and science will do the trick; for others, a powerful emotional story will get them to head into the direction you want them to go. And for others, you may never be able to change them no matter what you do just like some parents will never see the risk of not vaccinating, regardless of one’s efforts.

So, how will you get people to change in your medical practice?