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22 January 2018
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How to manage your peers

by Dr Iain Wallace

The challenge of managing your peers

As a medical leader one of the biggest challenges you can face is managing your peers. Essentially that means getting them to buy in to your vision or ideas and to change their behaviour accordingly. As a doctor the things you want your colleagues to do varies enormously from turning up on time for a shift through to improving your organisation’s standardised mortality ratio. Both require good leadership skills but need to be deployed differently depending on the context. If you want a colleague to change their behaviour it helps if you have an established relationship with them. So, building trust and rapport with colleagues is important even when you might not feel an immediate need to ask them to change or do something they might not otherwise be inclined to do. That can be achieved in many ways but being approachable and interested in them as a person goes a long way. Also being willing to help out (even better without being asked) is another way of building good working relationships. That by itself is no guarantee that you will get an easy ride but it’s definitely a prerequisite for being able to successfully manage colleagues. Being fair is a trait that also helps. It is not good if colleagues perceive you as having biases and are only interested in promoting things dear to you.  Good self-awareness through being open to colleague feedback can help counter unhelpful tendencies! 

Communicating with your team

If you want to be effective as a doctor leading a team it is important that you have defined goals and can communicate them clearly and with some confidence and enthusiasm (but not so much it’s a turn off).  However, in formulating your goals it’s important that you share your thinking and incorporate others’ ideas as appropriate. That way you don’t spring surprises on people and those whom you want to embrace your ideas etc will hopefully be half way there already in their own minds which makes your job all the easier. Having said that, don’t expect things to always go smoothly. They don’t, that much is guaranteed, and that is where personal resilience is also important (see another quick guide).  One way of getting people on board early is to arrange a meeting of colleagues to discuss your thoughts. This allows you to sense check them and invariably, as more minds are usually better than one, you get some helpful feedback that allows you to refine your idea. For busy colleagues writing a short SBAR and circulating it ahead of the meeting can be helpful.   

In some peer to peer situations you may have the luxury of position power, for example if you are a Chief Registrar or Chief Resident. However, it is important to see the use of position power as a last resort as the more you use it the weaker is its effect. You certainly don’t want to deploy it in situations where with a bit of effort you can achieve the result you are looking for.

Being persistent to achieve success

If things don’t go accordingly to plan don’t be discouraged. It takes determination and persistence to get things moving at times. Remember inertia is almost the natural state of things! Sometimes the reason colleagues don’t respond enthusiastically to your ideas is simply down to time pressures. That’s when persistence is helpful. However, if non-one is buying in to your grand plan then you need to spend some time with them understanding why that is rather than keep flogging the proverbial dead horse. Of course, if you engage people early there is less likelihood of that happening but there are also late adopters in most workplaces who resist change.  In some cases you can just work with the enthusiasts and eventually the others come on board but on other occasions the resistors can win through attrition, so identifying who they are likely to be ahead of time and working with them to build support is a wise move. This still isn’t a guarantee of success, of course. If things don’t work out don’t get down about it as it’s normal! Have confidence in yourself but use this opportunity to reflect on why things didn’t work out and apply that learning when there is another opportunity to work with your peers on another idea that you have. 

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