The skills of the change master

What are the fundamental skills for dealing with change? Presented here are nine skills that can help you become a change master in an uncertain and turbulent health care environment. These skills range from active listening to seeing the big picture. Managing change--whether solving a problem immediately or knowing that the best decision is to wait--will be fundamental for success.     

Habits of mind for turbulent times

How do you deal with change--in either personal circumstances or in the turbulent health care environment? Do you rail against the variables that seem to put you in the uncomfortable situation, blame yourself, take it personally? Are there ways to start looking at change differently and more effectively? Here's the key: It's all weather. Whatever you can't control, no matter who does it or why, is just part of the weather--where you are right now. How do we treat weather? We try to find out as much as we can about what's coming, but we keep its unpredictability in mind. We prepare for its extremes as wisely as possible. We grieve any losses it causes us, and celebrate the lovely spring days and quiet summer evenings it gives us. And never once do we take it personally, think that the weather is out to get us, or that lousy weather means that somehow we have failed. We just know that its not personal.     

Is it change? Or is it noise?

How can you tell the difference between mere noise, and a profound change headed your way? Your gut instincts may not always be a reliable gauge. It takes a long time for most people to become an executive leader. If you are typical, you were raised and trained in a different era, with different expectations. You see things with different lenses. So what can you trust? You can trust first principles. Ask yourself what you know about the reasons that changes are happening in this environment. Then ask yourself about what is being proposed--how does it fit with the roots of the changes in health care and your organization? The three change filters presented here can help you to figure out if it's change or just noise. Ask yourself: (1) what are the changes occurring in the health care industry; (2) is your organization ready for change; and (3) how likely is it that your organization will easily adopt this particular change? These three filters together will help you decide what is a truly important change, how ready your organization is for change, and whether it will adapt to this change with ease or difficulty.     

The best leaders

Today's movements away from authoritarian leadership emphasizes team development. People are experiencing with a leadership that empowers, rather than a leadership that is, itself, powerful. But how do you become a leader who empowers others? What are the characteristics of "best leaders"? From listening skills to getting feedback and including people in the process of change, effective leaders help others move towards the goal, ultimately thinking, "We did this ourselves."     

How do you communicate? Managing the change process

Change is a difficult and emotionally charged issue in any organization. Clear, effective communication is essential to deal with people's fears and expectations. Multiple tools and schools of thought are available to increase organizational effectiveness, including systems theory, TQM, and change management. Physician managers are under the gun to incorporate these ideas and use them to effect organizational change. But the biggest challenge is how to bring the techniques home and put them to use, one-on-one with another person. How can you become a more effective communicator and change agent? The basis for win-win relationships revolves around being aware of how we communicate--not just our words, but our body language and tone of voice.     

Thriving in change

The turbulent state of health care and the rapid changes that show no sign of abating point to many career-related challenges for physician executives. How can you predict the impact of these changes on your career? What measures can be taken to prevent any negative impact of change? And how can you prevail when dealt a negative blow like job loss? The signs that foreshadow the unraveling of a physician executive's career are described. The warning signs are: Not keeping up with change, losing your influence; getting negative feedback; turning your "concerns" into complaints; the economy working against you; and being blindsided because we think leaders operate logically. Being proactive puts more control in your hands and leaves less to chance. You can prevent being blindsided if you: develop your people skills; get comfortable and involved with e-business; stay abreast of health care trends; pick up the pace; and develop "You, Inc." There is a final component to prevailing over adverse circumstances--find your work-related passion and apply it to your career.     

Watching the falling barometer

How can physician executives create a vision, a strategy, in the face of such overwhelming forces for change? The answer has two pieces. The first is the Weather Channel: scanning the future for warning, for opportunities, for new business possibilities. The second leads us to such questions as: What is your situation? Financially? In market terms? It leads us, as well, back to the question: For you and your institution, what is your reason for being in this business? In other words, what is your foundation? If you can become clear about who you are and what you are here for in the long run, and match that with some sense of the technologies and the political and financial pressures headed your way, then you can begin to create a vision of a future that works for you. In the coming years, we will begin to create entire new ways of doing health care, new roles for hospitals, new types of medicine--and the time to begin the creation is now. If you wait until the hurricane hits, it will be too late.     

Are you obsolete?

Are you vulnerable, regardless of length of service at your organization and your unique skill sets? There are ways to test vulnerability and assemble some hard evidence that your management role makes a difference. You need to conduct a self-test for obsolescence. Ask yourself the following questions: Are your skills state-of-the-art? As a manager, how do you compare with others doing the same, or similar, job at competing organizations? Is your role essential? Where does your job fall into the big picture? Can you be replaced easily? If a thorough examination of your skills and your role convinces you that your contribution returns more to the organization than your salary, can you prove it? Consider these strategies: (1) Put together a portfolio, (2) ensure your boss' support, (3) advertise your successes, and (4) cultivate recruiters. The best reason to analyze your value to the organization is that if you are laid off, getting another comparable job--or a better one--will be far less of a hassle.     

Communication skills: a prerequisite for leadership

A man once said, "He who would be first among you, let him be your servant." I think he also would have said, "If you would be the leader of the troops in health care, you must be able to communicate." You must be a good listener, be able to facilitate conflict resolution, be a good interviewer, deal effectively with problem physicians and employees, speak effectively in front of an audience, and communicate well in writing. Do not assume that you are good at any of these skills because you went to medical school. All of us need improvement in these areas.     

Physician practice management companies: a failed concept

Is there a lesson? Famed investor Warren Buffet claims he never buys a company unless he personally understands the business. He admits he has missed a few real opportunities in the high technology sector. However, he is pleased to have avoided many disasters. Many physicians entered into PPMC deals without completely understanding the concept. Perhaps the lesson is to simply avoid a deal that does not make sense. Understand the market. Understand the business. If you, as a buyer, seller or partner cannot clearly understand how a transaction creates value that you can capture, walk away.     

Someone promised mentors: will you deliver?

What are recruiters promising? Many new hires say that they accepted a job because of a promised mentoring program--one that never materializes, and one that the manager doesn't know was part of the discussions. Where does that leave the manager who may not be aware of this expectation? Faced with anchoring mobile Gen Xers, organizations are exploring mentoring as an inexpensive way to improve retention. But mentoring is not a technique that can be applied like a warm blanket to solve the problems of orientation, training, skills development, and retention. There are two reasons why mentoring isn't foolproof--the mentor and the protégé. If you are considering a mentoring program, or becoming a mentor yourself, here are some points to ponder: (1) If you can't (or won't) do it, give convincing reasons up front; (2) establish the rules of engagement; (3) a mentoring relationship doesn't guarantee loyalty; (4) having a protégé has political risks; (5) you can't force anyone to take advice; and (6) expect a quid pro quo.     

Changing what goes on in your head: how to stop "ain't it awful?"

How can you change your negative thinking? This column describes a process that, on the surface, seems too simplistic to be beneficial, but that works: choose a few good words to repeat to yourself constantly, progress to better thoughts, and then improve what you say to others. If you want to be more satisfied with your work life and your personal life, you must change the internal dialogue in your head. If you have some version of negative internal chatter, you need to substitute positive statements. You need to say something different from what you have been saying every spare minute of the day. You must say it even if it is the biggest lie you have ever heard yourself think. You must say it for days or weeks before you notice a difference in your attitude, relationships, and health. Eventually, you will notice you feel better and people are behaving better.     

Will you be ready when the pink slip arrives?

Are you prepared to ride the waves of change? Will you be ready when the pink slip arrives? Health care executives who can jump a little higher and run a little faster will go further in the draft. Those of you who are prepared for change will always be appealing to recruiters and prospective employers. How can you ride these turbulent waves and not capsize? This article explores some suggestions for positioning yourself: Proper positioning with the inevitable changes in mind will help you move your career in a forward direction.     

Finding the essential difference

The idea of what is essential and what is peripheral is basic to all intelligent management of change. At the core of all our resistance to change is the fear that we will lose something of ourselves, something unrecoverable. "Touching ground"--gaining clarity on what we are truly about, and shaping our strategies around that core--is a key skill of the change master. What is the most important element in helping people deal with change? According to Roger Fritz, President of Leadership by Design, Inc., a St. Louis consulting firm, "Helping them recognize what's essential. There are two kinds of change: Technical change and profound change. A technical change asks you to learn something different. A profound change ask you to be someone different." Too often, we confuse the two and are met with resistance.     

Power negotiating for physician executives

Whenever you deal with another person, you use exactly the same techniques that international negotiators use to reach agreement on world problems. Learning to improve your negotiating skills is the highest and best use of your time. You can't make money faster than you can when you're negotiating well. Presented here are negotiating gambits to use to your advantage at the bargaining table.     

Influence by learning how people process information

To have a successful career in management, you have to pay more attention to refining your communication skills than you ever thought was necessary. In a survey of 100 physician executives, 94 percent felt training was needed in communication skills if you are thinking about becoming a physician executive. When recruiters talk to us about the basic requirements for physician executives, one of the things they say the person needs to have is excellent communication skills. Most people have good communication skills, but what can move you into the category of excellent is paying careful attention to how the person you are talking to processes information. You can only do this if you listen before you do much talking. What do I mean by processing information? When we get up in the morning, the world is out there separate from us. We have to take in information about that world and make decisions all day long. We don't all do this in the same way. In this article, I am going to discuss four ways to process information.     

Living in the question

We live in a fast moving-world. Business has accelerated to breathtaking speeds in the 1990s--and in the last few years the afterburner has really kicked in. The speed of change is overwhelming. Especially in health care, who has time to "live in the question?" We need to decide things quickly, get the decision out of the way, and move on, right? Maybe. Biology shows us that you can't plan ahead very far. New things come along that you don't even have a category for, and therefore you don't even see them. Things are going to happen that you literally have no notion are even possible. The key to succeeding in this environment? Don't plan ahead. Stay curious. Make small bets. Build organizational hothouses. Feed the seedlings that grow. The challenge is to remain curious, to live in the question, both personally and organizationally.     

Where can we learn about change?

Presented here are some resources--books, consultants, and personal growth practices--that you might find useful in the struggle to become adept at dealing with change. Mastering change is a long process, but unlike building a cathedral or growing apples, as soon as you start you will have something that you can use--some insight, a different way of looking at what is confronting you, something to help jar you to a more creative strategy.     

The MBA mystique

Is an MBA the solution for you? Do physician executives need to have a business degree to compete in today's competitive marketplace? What are clients looking for when they make hiring decisions? The answers may surprise you. This column is an attempt to dispel myths about physician executives and the MBA degree. Clients want to attract and hire physician executives who possess sometimes intangible skills--with or without the MBA credential. These intangible skills include the ability to educate other physicians to the new health care realities, a sales orientation emphasizing effective communication that focuses on patients and payers as customers, comfort with ambiguity, flexibility, and tact and sensitivity in negotiations.     

Negotiate the salary you want

How can physician executives negotiate the salary and terms that they want for a new position? The idea of negotiation raises the anxiety level of all but a few people, those who thrive on the thrill of competitive bargaining. Most physicians do not relish the process and view it as a type of conflict. But without knowing what you want to accomplish and preparing to ask for it, you may well leave the meeting frustrated and unhappy with the offer. Determine what you want before you get into an important negotiation. You will get clear on what you want much quicker and you will remember the points better when you talk to the other person.