Hard changes or hardly changing - leadership in general practice

The Person Centred Medical Neighbourhood Readiness Program (PCMNRP) has been looking closely at this very common problem. We have all read the how-to books or watched the TED talks, but whenever we try to make a change in our practice, it invariably falls by the way side or simply fails to get off the ground at all. This can be immensely frustrating for any change leader.

Scott Keller and Carolyn Aiken from Mckinsey and Co said that:

The prescription is right, but rational managers who attempt to put the four conditions in place by applying “common sense” typically misdirect time and energy, create messages that miss the mark, and experience frustrating unintended consequences from their efforts to influence change. Why? Because when they implement the prescription, they disregard certain, sometimes irrational—but predictable—elements of human nature.

The PCMNRP is currently working with around 20 practices who are trying to instigate change. We want to share their experiences to help you appreciate the “sometimes irrational - but predictable – elements of”… your practice team. These brief articles might help you to understand why it is so hard to make meaningful change and hopefully give you some new tactics to try.

This week we will look at leadership. We cannot stress enough the need for a charismatic leader to enable change. The most successful practices have a GP driving change and generally a principal. Staff will need to find a GP who is willing to negotiate with the other GPs on a level that staff simply cannot. Without GP buy in, you will find change almost impossible. Remember that GP time is precious, so if you are approaching a GP to be your leader be well prepared, give them plenty of notice and a brief description of your idea in advance. Some of our Practice Managers undertook their changes without GP buy in and found that GPs came on board later once the change was underway. One practice even managed to get a principal involved eventually.

If you are a GP, then consider the following observations from a recent workshop held for GP students about leadership. The students listed qualities of leadership which included:

  • Inspires intrinsic motivation over fearful motivation
  • Kind and humble
  • Supportive
  • Courageous
  • Walks the talk
  • Can delegate and defer
  • Provides and responds to criticism

All were regarded as essential leadership qualities.

If you have a leader then you need to employ the classic change management techniques, but unfortunately that is often not as simple as it sounds.

Next time will talk about the need for a great story, which is generally the first chapter in the text book. But beware, even that may not be as simple as it sounds.

For more information about the Person Centred Medical Neighbourhood, or if you would like to provide feedback on this article, please contact d.scandol@cesphn.com.au.

CESPHN is running a GP leadership training program to help develop our leaders of the future. Our next event is on 20 September 2018 however spaces are limited. If you would like more information or to apply to attend, please contact d.scandol@cesphn.com.au. pdf Click here (751 KB) to view the flyer.