Month: November 2007

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Tips for confronting unknown jargon

Beware when using jargon; look out for quizzical facial expressions or surprised gestures in your audience.  Invite queries; say something like, “Does that make sense?”, or “You look like I’ve said something you don’t understand?”

If you hear unknown jargon, you can wear a surprised expression, or try:
“I’m not being funny, but what does …. mean?”
“At the risk of seeming ignorant, can you explain what you mean by… please?” 

Try and say these questions in a light-hearted tone of voice.

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Jargon

Clinicians and managers often rub each other up the wrong way.  There are a hundred and one reasons, but one common one is the use of jargon.  I have seen doctors become almost apoplectic when certain words are used by managers:  ‘robust strategy’, ‘congruence’, ‘going forward’!  This is all the more ironic when you consider how often doctors use their own medical jargon.   Indeed, sometimes doctors delight to use words they know the managers won’t understand.

 Jargon is useful short-hand when people have a shared understanding, but should be avoided with ‘lay’ people as it simply obscures meaning and raises suspicions.  Clinicians know this from their training, when care is usually taken to use straightforward words with patients.

So, be self-aware when choosing your vocabulary and check to ensure that you understand what each other means.  Don’t be intimidated by new words, but rather verify meaning by asking explicit questions.  Generally, people are impressed and pleased because some of them might not know what’s going on!  You will be seen as honest and open, which is a likable trait.

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Sensitive projects

When people refer to ‘sensitive projects’ they nearly always mean dealing with difficult people. Usually, this means individuals who are described by colleagues as, ‘unreasonable’, ‘aggressive’, ‘opinionated’, ‘a refusnik’. There will also undoubtedly be a ‘personality clash’.

Thus, it is not the project that is ‘sensitive’, it is the people involved. Therefore, concentrate on the people issues and don’t waste time on the surface manifestation, which may be some narrow, clinical or technical issue. If you get distracted onto the surface issue you will get bogged down in expert opinion, which will become ever more narrow, leading to a dead end. Insist on working on the people issues and the technical ones will take care of themselves!

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Tips for chairmen

Useful phrases to use during a meeting, (especially when dealing with people who love to hear the sound of their own voices!)

• “This meeting is about…… and by the end we should have clear actions for ….”
• “Let’s remind ourselves of the ‘ground rules’” (i.e. show mutual respect, one person talking at once, avoid shouting, let everyone contribute, be open and honest, etc)
• “I think we should hear from ……. on this”
• “Can we have some comments from …..on this, please?”
• “You’ve expressed your point very clearly, and I think everyone has understood. Is that right? Good, so let’s move on to….”
• “You obviously feel strongly about this. Can we talk more about it after this meeting?”
• “It’s difficult to concentrate when more than one person is talking at the same time”
• “So, to sum up that point…..”
• “Let’s take 5 minutes to freshen up”

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Advanced Chairmanship Skills

Clinicians are often asked to chair meetings. These can range from purely clinical ones through to managerial, or even public ones.

Often doctors are asked to chair meetings simply through deference to their position, with little consideration given to their abilities as a chairperson. It is therefore no surprise when they do it badly; I guess we’ve all been at meetings where we have inwardly groaned at the poor performance of an ‘eminent’ chairperson.

Here are some of the essential competences of an effective chairperson:

• Purpose:
– thank people for coming and explain the purpose of the meeting. Seek agreement on the purpose.
• Impartiality:
– Avoid giving your opinion but let everyone else have their say
– Don’t ‘side’ with anyone
• Assertiveness with gentleness:
– Prevent interruptions and stop one person dominating (see ‘Useful phrases’)
• Stick to time:
– limit the agenda, consider taking contentious issues ‘offline’
• Summarise:
– Sum up the item/meeting: either do it yourself or ask someone who hasn’t said much to do it
– Confirm the actions and who is going to do what

PDF version here

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Pause techniques

It can be very helpful to have a trick or two up ones sleeve to do whilst in pause mode.  Taking a deep breath in, holding for a second or two, and slowly exhaling, helps to control the tendency to hyperventilate when angry/upset, and also appears to others that you are ‘in control’ and being thoughtful.  Personally, I also like to put a hand over my mouth (fingertips on lips pointing up).  This gives a clear, non-verbal indication of “I’m listening and thinking carefully about this”. Using a pause, is the first lesson in gaining control.

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‘Diagnosis’

Jim (Learned helplessness) was faced with what seemed an overwhelming task. 

This is quite a common experience for clinicians presented with managerial/leadership challenges; after all, they’ve rarely been trained how to deal with them.   But, in my experience, it is perfectly possible to think of managerial issues (notice the use of the word ‘issue’ rather than problem – sounds less negative!) as if they were clinical ones.  In other words,  use the clinical, diagnostic skills that have been learned over many years and apply them creatively. 

For example, when faced with a patient, the clinician will apply a tried-and-tested diagnostic approach, namely, history, examination, investigations, treatment.  ‘History’ means gathering information about the ‘presenting complaint’ (in Jim’s managerial case the ’18 week’ policy).  So, in the same way that patients’ relatives and GPs  can give vital information about the patient, there will be other people in the organisation, or wider health community (e.g. PCT, SHA, etc), who will already know a lot about the 18-week issue.  There will also be information on the Internet, e.g. the 18-week website.

Jim is not alone in his task.  He can utilise others’ help.  I’m surprised how often clinicians try to ‘go it alone’.  There’s usually no need, indeed, it can be quite counter-productive.  Tips on collaboration