The successful physician negotiator

Whether you realize it or not, you are in the middle of a negotiation every time you are asked to do something. Negotiation skills are important for physician executives, both in their professional and personal lives. The Successful Physician Negotiator: How to Get What You Deserve provides useful examples of how to negotiate and helps you get in the proper mindset to get it done effectively. While the book explores the concept of cooperative negotiation, which is important if you want to have a long-term relationship with a person, it's also important to have other tactics. You need to understand your opponent by gathering information about his or her values and work situation. You can gather information when talking to your opponent, but you also need to do some "behind the scenes" preparation before the encounter begins. Other recommendations include: don't negotiate in your office, use time to your advantage, be able to keep silent when necessary, have options, be able to say no and walk away, keep your cool, and take notes.     

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.     

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.     

Medicine, management, and me.

What is medical management? How do you learn about it? How do you get into it? Is there a future in it? Is medical management for you? Can you do it? What will it mean to your original plans for your life in medicine? Is it worth the sacrifice? Get comfortable. I have a story to tell you. It may help if you hear about medical management from a medical director who has preceded you. I doubt I can answer all your questions. I can, however, tell you about one physician's visions, expectations, decisions, experiences, and rewards from what can be loosely called "medical management." If you find something of help in your decision making in this account, my telling it is worthwhile.     

How to cope with behavioral interviewing questions.

What should a potential employee do when asked behavioral or highly intrusive questions during the interview? Here are some suggestions to help you be prepared should the interviewer ask you personal or objectionable questions: (1) Take some time for introspection; (2) be prepared to draw the line; (3) complain; and (4) write it off. And remember: A show of determination and setting boundaries in an interview may advance your progress. Coolness under fire is an attractive personality trait.     

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.     

Communication tips for the job search and on the job

Listening, speaking, and nonverbal skills are the most important success factors in getting a job or being effective in your current position. If you don't communicate well, your technical knowledge won't ever be put to good use. Recruiters, hiring organizations, and bosses are looking for people who can play well with others and can sell. Playing well with others involves listening and having self-control about what you say. To sell yourself and your ideas or products, you must speak well. You also must be well-groomed, look energetic, and sound reasonably happy to be at work. Good listeners: Stop talking; ask open-ended questions; para-phrase, restate, or summarize some of what the person had said; and talk about feelings. Effective speakers: Have voice mail etiquette; are courteous and tactful; don't react to a verbal attack; don't engage in verbal attacks; use the right amount of words; don't say too much; prepare ahead of time; and decide whether they should speak or write their message. And remember the power of body language or non-verbal skills--how you look and sound. Experts estimate that 65 to 90 percent of what you communicate is nonverbal.     

Delegation can make (or break) your career

Delegation is not a soft skill. Physician executives who do not delegate well and strategically cannot expect to achieve the top jobs now or in the future. It's not enough to have great communications skills to convey your vision. You won't achieve that vision alone; you must have a great team to bring that vision to fruition. However, you can't delegate your first and most important step--self-assessment. To maximize your strengths and minimize your weaknesses, you'll need a clear view of what makes you tick. Then start thinking about your executive role in these terms: Conceptualize work mandates as projects; choose people who are better than you for your team; and try to work yourself out of a job. By learning to delegate, physician executives can make their own careers (as well as those on their team) richer and more fulfilled.     

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.     

Welcome everything

The failure of management is largely a failure to bring our whole selves to it. What parts of your self do you bring to your work? Do you bring only the management mind, only logic, only the company guidelines? Or do you bring your passions, your values, your soul, your deepest self? Do you react? Or do you respond? Letting go of what you think you know can be the first step to a creative and powerful response. Many of the tools we use in management can actually remove us from the experience and make it harder to respond. Reacting closes down options. Responding opens up possibilities and nurtures trust. This is kindness transformed into a business imperative--responsiveness.     

New, customized news

How can you get the news that you want, when you want it, no matter where you are? The idea of customized news is indeed new. Instead of sitting passively in front of the TV or turning the pages of your newspaper, you can program your computer to search for the news that is of interest to you from myriad sources. The idea of getting the news as you like it is all a product of the wonderful world of cyberspace. Browse the Web and find out if these news services are right for you.     

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.     

Putting "teeth" in your résumé

How can physician executives get the kind of management experience they need to move to the next level? Is the MBA the end all or can significant management experience and top assignments impress recruiters and CEOs? Here are some important questions to ask yourself about each job you have held as you prepare to move forward in your career: How did I improve the organization? How did I contribute to greater efficiency? How did I affect productivity? How did my work increase the bottom line? Thinking about these questions can help you put teeth in your résumé and get you where you want to go. When you can answer those questions from your own experience, you will have created a powerful career track record that is likely to impress the next CEO whose staff you want to join.     

What to do next

Why do we work? While there may be some obvious, practical answers to this question, like needing to make money to survive, there are other reasons that people work. These include working: to have stimulation and excitement--to meet new challenges and have variety in your life; for love and affection--to be with colleagues, clients, customers and to provide security and protection for family and friends; and to leave a thumbprint on the world and change individuals, systems, and institutions. For quality life, it is necessary not only to work but to enjoy your work. For physicians considering careers in medical management, the key to success is being truly excited about management activities. If you are heading towards management, you need to view some of the tasks as fun or you probably won't stay with it very long.     

Health care is sales

Health care is all about sales--everyone today in the competitive arena of health care is a salesperson. Your selling days began when you applied to medical school. Your product was yourself, and you worked hard to sell it. That was only the beginning. In your daily work as physician executives, you are selling yourself and your ideas-your ideas about relationships, management structures, partnership issues, merger questions, etc. It's a complicated world, and the concepts are often abstract and difficult. But it is your job to communicate with others to get things done. It is the most important part of your job. It is selling, in fact, at a sophisticated level. How do you communicate and sell yourself and your ideas effectively? Here, some ideas on how to listen and communicate.     

Got curiosity?

The newest scientific models of decision-making suggest that the way we actually decide to do something is different from the story we put on it later. Organizations think that way, too. The real process of decision-making is hidden. Management is complex--and a key tool is curiosity. A critical question would be: "What experience are we creating?" When you get curious, separate what you notice from the story you tell yourself about it--even if the story is true. Look for the meaningful experience: your own, your employees', your customers', your physicians'. The essential act of management is to notice, to not look away.     

Acing the 'chemistry' test

With the right boss, you can go far and learn much. The wrong boss could actually slow or even stall your executive career. When you interview for a job, you're also interviewing for a boss--and it's in your own interest to try to find the individual who is the best possible fit with your own management style. This is a matching process--not quite a courtship, but with some of the same characteristics. What can you do to ensure a good match with your new boss? (1) Do your homework; (2) Make your interview a dialog; (3) Use subtle strategies, too, such as watching for body language; (4) Ask the employer for references; and (5) Know yourself.     

Getting started as a physician executive

In clinical practice, technical skills often outweigh interpersonal and leadership skills as success factors--you can be a great doctor and a so-so person. But the reverse seems to be true in the physician executive role; it is precisely the intangible leadership skills that contribute to and determine potential success. And they can be tough to master, especially when you focus on them for the first time, partway through an already-successful career. Practicing leadership is like practicing medicine. It's not just a matter of learning some new things--if it were only that, physicians are known to be excellent learners. Nor is it just a matter of determination or application--this is not a battle that sweat and effort alone can win. Most physicians will want to "try on" the executive role before making strategic moves in that direction. But be clear about what you want to get out of any project or activity before you jump in. If you're seeking a management degree, the best approach is to tie together developing your technical and interpersonal skills, as well as the formal credentials.     

When it's time to say goodbye

You've landed the perfect job, but now you must face your current employer and deliver the news that you're leaving the organization. While an exciting time, this can also certainly be a stressful one. Here are some strategies and ideas for saying goodbye to an employer that may be useful in guiding your actions. From being ready for counter-offers to downright hostility, you need to be prepared to deal with various scenarios. No matter how you have steeled yourself to go into the boss's office to share your news, you cannot predict with total accuracy just what his or her response will be. There will always be surprises, although usually things are never as bad as your imagined worst-case scenario. However, when you are ready to make your plans known, one simple rule is always required: You must have total commitment to your new position.     

Physician leader, be careful not to let arrogance stand in for competence

At various points in your physician leadership career you may feel such a sense of mastery that you delude yourself into believing that you are better than you are. Depending on the size of your ego, that time may come sooner or later than in your peers, but, be mindful, it could come.