Stuck in the middle with you. Getting to know your partners

You’ll have heard the mutterings in the staff room when some change is proposed or an unexpected situation arises.

‘Dr W? – don’t bother asking him.  He’s just a grumpy git.  All he’ll do is moan.’

‘Oh, you can ask Dr X to do anything and she’ll always oblige. Nothing is too much trouble for her.  That’s why all the heart sinks come to see her.’

‘Don’t bother making any suggestions to Dr Y if they cost money.  He’s got moths in his wallet.  He freaks out if the petty cash is a penny out.’

‘And as for Dr Z – if it makes him look good, then he’ll go for it.  He thinks he’s Archie.  (a good Scots expression for a vain or arrogant person)

New initiatives, changes to QOF, requests to take part in research – in your role as Practice Manager, some you can safely bin, others demand action.  It’s easy to work on the basis of broad assumptions about likely reactions from the partners but do you ever wonder why they respond in the way that they characteristically do?

When working with a previous partnership, the doctors and I spent a relaxed afternoon in a local hotel, (a capable locum minding the shop), had tea and some of their legendary scones and then  took a big step back to talk about some underlying beliefs and hopes.  Real personal stuff.

‘Why did you become a doctor?’

‘How has your time in general practice worked out for you?’

‘What’s really important about your daily work?’

‘What do you hope and fear about the future of the practice?’

The answers were illuminating, a few tears were unexpectedly shed and some interpersonal barriers were at least partially demolished.

Without breaking confidences, I can report that a very clear picture emerged of the many shared values held by the partners, but more importantly, the very different motivating factors in all three.

Here’s a simple diagram to illustrate the point.  These were the key drivers for each of the doctors.

marion-duffy-diagram

It wasn’t difficult to see why arguments would typically go round and round, and decisions would create conflict.  From then on I was able to use my powers of influence in a more targeted way when seeking buy in or consensus, through pre-empting negative responses and providing reassurance around anxieties or perceived threats to what each of them held dear.

Of course the doctors should have turned the tables on me.  If they had, and we’d substituted ‘Manager’ for ‘Doctor’, I suspect I would have had to own up to –

  • Always striving for perfection
  • Struggling to live with chaos
  • Wanting to be everyone’s friend

as key drivers (often unconscious) in the way I managed the practice.

And if I’ve learned anything in the intervening years, it’s that it can be very hard to be any other way.

So you might want to think about getting to know your partners – and yourself- just a little bit better as you plan for how to manage the latest round of QOF changes.


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