“… if you take it away, it’s all people can think about. The instant people perceive disrespect in a conversation, the interaction in no longer about the original purpose – it is now about defending dignity.” (Crucial Conversations, by Patterson, Grenny, McMillan and Switzler).
Dr. Monica Broome, MD, shared this quote today in a presentation on Practice Culture at the first ever MGMA/AMA Collaborate in Practice Conference in Colorado Springs. The conference is focused on creating effective partnerships between administrative executives and physician leaders.
Monica is a professor at the Miller School of Medicine in Miami where she is the Director of the Communication Skills Program and studies the neuroscience of communication. Her talk focused on developing a positive culture in group practices through enhanced teamwork and communications, ultimately developing a patient-centered culture.
Regular followers of my blog know that I focus on the Lean principle of Respect for People in the work I do on physician burnout.I see Lean, done right with Respect for People, as a key to preventing burnout.The problem is that too often, Lean is done wrong, without the respect.
This is at the heart of the struggle to get physicians engaged in Lean transformation work.Why should physicians engage in work that will significantly change the way they do their work?They are busy doing the really important work that saves lives and generates revenue.Let others do the mundane bureaucratic work of redesigning work flows.
Is this the real reason, the root cause of why physicians don’t engage in Lean?Or, is it because it has been presented to them in a way that does not respect them and the work they do?
Lean is often introduced without respect for the physician.
- They are told, “We will remove all the non-value added waste from the work you do.”
- Others don’t understand that what some see as waste, physicians experience as barriers to their efforts to do the best they can for their patients, and they feel that frustration deeply every day.
- And there is a real impact on patients and colleagues when they are away from the office or hospital.
All of that can be interpreted by physicians as a lack of respect.And so they respond by defending their dignity.The work they do is the most important.They just can’t be away from the patients.They certainly aren’t interested in participating in an event that demonstrates that they are less than fully effective.
It’s easy to fix this.Start with respect.Let them know that you understand that they are frustrated by the current state.Listen to their thoughts about what the problems really are, where the root causes lie, and what experiments are worth trying. Look for creativ ways to cover the practice when they are out.Ask questions and wait for the answers.
Once they don’t have to defend their dignity, and aren’t thinking about where their next breath will come from, physicians will become your strongest advocates.After all, they are scientists by nature who are continuously working to improve the health of others, why not the health of your collective practice and its culture?
What do you think?
Have you had times when you inadvertently treated physicians in a way that lacked respect?
How did it go? And what did you do to improve that process?