Quality Directions Australia Influencing Medical Staff A major point of difference

Quality Directions Australia Setting the scene Non medical managers often have considerable difficulty working with doctors They may be scared of doctors, overawed by doctors, belligerent towards doctors The often see doctors as a necessary nuisance to be dealt with as little as possible They are the victims of “the doctor mystique”

Quality Directions Australia The doctor mystique Doctor definitions A rarefied being who doesn’t live in the real world A person whose purpose is to block any change in health service management Someone who wants everything done for them but will do nothing for you Someone who refuses to understand how health services are run Someone whose only interest is money Etc etc

Quality Directions Australia The doctor mystique If the doctor is a unit head- the degree of difficulty in dealing with him/ her increases 2 fold If the doctor is a professor, the degree of difficulty in dealing with him/ her increases 10 fold If the doctor is a surgeon- its anybody’s guess!

Quality Directions Australia The doctor mystique How real is the doctor mystique? Is there a secret to managing doctors? Are there ways of getting them on board in furthering the aims of the organisation? How can the medical manager show their value in the organisation by managing doctors?

Quality Directions Australia The 4 rules of engagement Basic principles of working successfully with medical staff Build trust Understand what doctors value Involve medical staff judiciously Demonstrate the outcomes

Quality Directions Australia Building trust Deliver on promises AND deliver faster, better, smarter Never promise what you can’t deliver If the answer has to be no, say so and say why Where possible, make no sound like yes Assist in solving problems by providing options If someone is seeking assistance, do all you can to assist, within the parameters available

Quality Directions Australia Building trust Listen empathically to their issues Put yourself in their shoes Continuously provide open and honest information Data is very powerful Treat doctors with respect Conditional and unconditional

Quality Directions Australia Understand what doctors value Understand the professional group Professional group values and behaviours Understand the demographic groups Graduating year/ ethnicity/ gender Understand each influential individual Identify and understand key influencers and their sphere of influence Define the “hot” buttons What drives them and what will drive them away

Quality Directions Australia Understand what doctors value Understand what frustrates them Things that make their clinical work more difficult or take them away from clinical work Know who/ what is influential with groups and individuals Build trust with these so you can enlist their assistance when you need it Develop mechanisms to make “your” problem, “our” problem Includes data/ competition/ demonstrating adverse outcomes Remember that they are people first, doctors second

Quality Directions Australia Involve doctors judiciously Never waste their time Maximise time for clinical work Involve them in things where you know they can add value it is rare that they refuse to do this Reward/ recognise them for involvement based on their ”hot” buttons Match the acknowledgement to the person

Quality Directions Australia Involve doctors judiciously Ask them for relevant advice and listen to what they say Listen, understand and take things on board Be prepared to change your opinion and say so Learn to understand the issues Respect their opinions- unconditional respect

Quality Directions Australia Demonstrate the outcomes Ensure you let doctors know why we need to take a course of action Spell out the options and the advantages of the chosen option Ensure memos explain the why Promote the benefits to them both as individuals and professionals and also benefits to their patients

Quality Directions Australia Demonstrate the outcomes Demonstrate how working towards organisational goals will fulfil their goals (WIFM) Treat the past with respect so outcomes build on past efforts Provide a very clear vision of success

Quality Directions Australia Approaches Use the 5 characteristics of emotional intelligence Self-motivation Show you are doing things for the greater good, not for yourself Enthusiasm and commitment Self-awareness Understand which approach to use when Be candid Admit failure if this happens

Quality Directions Australia Approaches- Emotional Intelligence Self regulation Manage your emotions and impulses Integrity Not impulsive Empathy sense how others feel Listen empathically Aware of body language Social skills Build teams Friendliness

Quality Directions Australia Issues impacting on successful engagement Lack of trust Have lost their trust Not there long enough to have gained trust Based on doctors’ past experiences with others Unable to work out what they value Not good at selling a vision Lack of credibility Poor EI skills Dealing with the intransigents

Quality Directions Australia Managing the issues Involve others who have: Credibility A trusting relationship Good EI skills High level selling skills Use: Others on your team Other influential doctors you can get on side Other colleagues who support your ideas Consultants

Quality Directions Australia Managing the issues Dealing with intransigents Get them on your team- “keep your friends close and your enemies closer” Concentrate on the enthusiasts and fence sitters first, some will come on board Neutralise the really difficult ones by having key medical influencers on side Identify and celebrate all successes as you go Keep them in the loop about what is happening- they can’t ignore change forever

Quality Directions Australia Managing the issues Use of engaging consultants Build trust quickly if have the right skills Seen to have no “baggage” Excellent catalysts for rapid change Doctors will happily share all of their issues, so quickly learn what they value Gets over the “prophet in own land” (credibility) problem Can sell your vision unobtrusively Seen as an “expert” Ensure you have the right consultant for the job

Quality Directions Australia Is there a doctor mystique? Only if that is your perception Doctors are human too Treat them like you should all people With respect (conditional and unconditional) Be empathetic Provide assistance if they need this Be honest and open Understand their group and individual needs Explain the parameters

Quality Directions Australia The medical manager’s role Understanding the rules of engagement Becoming an expert in the rules of engagement Continuously educating themselves in influencing skills Keeping abreast of factors that motivate medical staff Making themselves indispensable in their organisations by being the expert in engaging and influencing medical staff Delivering positive outcomes faster, better, more comprehensively than anyone else