How to manage upwards (and sideways)

By Dr Claire Edwin and Dr Keerthini Muthuswamy

National Medical Director’s Clinical Fellows at NHS England and Improvement, and the GMC, respectively, and FMLM Douglas Fellows 2021/22

“Definitions of leadership refer to an individual’s ability to influence, motivate and enable others to contribute towards organisational success. Influence and inspiration separates leaders from mangers, not power and control”. [1]To be a successful leader, you need to be a successful influencer. Influencing is a key part of our day to day lives, the exchanges we have with our partners, our families, and our colleagues often involve negotiation and influencing in some capacity.

We recently discussed ‘How to manage upwards (and sideways)’ with Dr Rachel Morris, GP and coach, on her podcast You Are Not A Frog. In this episode, we discuss what we have learnt about influence during our time as junior doctors, and as National Medical Director’s Clinical Fellows at FMLM and our respective host organisations NHS England and Improvement and the GMC. We recognise we have been placed in positions and situations this year where we feel listened to and respected, which felt relatively novel for us. However, during our discussions with Rachel, we established that doctors could influence, regardless of position.

In the podcast we talk about the model of influence by Cohen and Bradford in their book ‘Influence Without Authority’[2]; which advises to assume all parties are potential allies, to clarify your own goals and objectives, diagnose the worlds the person you are negotiating with, identify relevant currencies (theirs and yours), and to influence through ‘give and take’, accepting compromise.

Reflecting on our time as clinical fellows and as doctors in training, we realised that some of our key successes have been through building relationships, trust and collaborating with each other and other colleagues and peers. We also recognised the importance of developing and maintaining professional relationships and networks.

We will both return to clinical training later this year and want to ensure that we can continue to use and develop our leadership skills, while recognising that neither of us are likely to be in positions to influence national projects. However, we have learnt that we can stimulate and inspire our colleagues, be they junior to us, peers or more senior. We now understand that we each have the ability to influence, giving us motivation and belief that we can make positive changes in any team, organisation or system that we work in.

Looking to the future as leaders and managers of teams and services, we found this conversation and reflections on influence particularly enlightening and important. Individuals and teams are empowered when they know what they are expected to do, how they are expected to behave and the degree of autonomy afforded them, which leads to them feeling valued and trusted. This in turn creates an organisational culture that harnesses innovation and creativity, improving transformation and improvement.

These reflections highlight the relevance of the FMLM Leadership and Management Standards for Medical Professionals and demonstrate that no matter your level  in a hierarchy, you can still influence, and moreover you can influence with integrity by knowing and living your values and through authentic leadership.  

Listen to the You Are Not A Frog podcast: How to manage upwards (and sideways)

[1] Nayar, Vineet (August 2, 2013). Three Differences Between Managers and Leaders. Harvard Business Review (hbr.org) Accessed at https://hbr.org/2013/08/tests-of-a-leadership-transiti

[2] Cohen, Allan R, and Bradford, David L, (2005). Influence Without Authority. Wiley, Hoboken, New Jersey.