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Negotiation skills and dispute resolution methods are necessary to leading an effective practice

Article-Negotiation skills and dispute resolution methods are necessary to leading an effective practice

Key iconKey Points

  • There are reportedly five distinct decision-making styles; therefore, it is often best a one-size-fits-all approach to influencing decisions.
  • Understanding decision-making style of one's business partner, office manager or potential patient can help the surgeon tailor communication for a positive outcome.
  • Most surgeons are either "thinkers" or "skeptics."

NEGOTIATION SKILLS and dispute resolution tactics aren't taught in medical schools or stressed during those all-important surgical fellowships, but these management maneuvers are as vital to leading a successful surgery practice as a fine-tuned scalpel or a high-tech laser. And arguably, they are perhaps even more critical for cosmetic surgeons than for their counterparts in other medical specialties because out-of-pocket fees associated with aesthetic procedures demand that cosmetic surgeons have a heightened sense of business acumen. However, while most cosmetic surgeons understand that effective management of a large practice or surgi-center requires delegation of administrative duties to managers and staff personnel, most still need help with effectively managing the managers.

Negotiation and persuasion skills are paramount to the role of a cosmetic surgery center leader. The obvious uses for persuasion and negotiation would be in the marketing of aesthetic procedures to potential clients, but this only scratches the surface. Everything from getting the best possible terms from a laser supplier to obtaining optimal performance from a difficult, but talented, staff member or physician-partner hinges on the nuanced aspects of negotiation and persuasion.

SURGEONS ARE SPECIAL Gary A. Williams, who wrote about persuasion tactics and decision-making styles in a seminal Harvard Business Review article, points out that surgeons are often enormously confident, but that there can be a fine line between confidence and cockiness. "If you're dealing with a peer and trying to get conflict resolution, it's helpful to enable the person to be right about something so they can back down without losing face," Mr. Williams tells Cosmetic Surgery Times . Another technique to help bring others on board when you are, for instance, proposing unpopular schedule changes is to introduce new information into the conversation after descent is voiced. "Once you introduce new information, you give the other person the right to change their mind — to come over to your side — without appearing to give in because now they have information that they previously had not considered," Mr. Williams explains.

THE FIVE STYLES In the paper, "Change the Way You Persuade," which Mr. Williams co-authored with Robert B. Miller, the pair report that there are five distinct decision-making styles, and that it is best to avoid a one-size-fits-all approach to influencing decisions: "Charismatics" are intrigued by new ideas; "Thinkers" require data to make a decision; "Skeptics" are suspicious of data that does not fit their world view; "Followers" make decisions based on how other trusted professionals — or even they themselves — have made similar decisions in the past; and finally "Controllers" focus on the facts and analytics of decisions because of fears and uncertainties. Knowing peoples' preferences for hearing or seeing specific information at certain times in their decision-making process can substantially improve one's ability to tip the outcome in their favor, according to Mr. Williams.

Understanding the decision- making style of one's business partner, office manager or even a potential patient can help the surgeon tailor communication for a positive outcome, he suggests. Most surgeons, says Mr. Williams, are either "Thinkers" or "Skeptics." Thinkers can be the toughest professionals to persuade; they are impressed with arguments that are supported by data and they tend to have a strong aversion to risk, the co-authors write. Skeptics, they note, tend to be highly suspicious of every data point and often have a take-charge personality.

Recognizing one's own decision-making style and then hiring or partnering with those whose decision-making styles balance out your own strengths and weaknesses works to he advantage of the entire practice.

"If you are a 'Charismatic' (aka, a risk-taker), it's often best to hire a 'Thinker' or a 'Skeptic,' to balance out the decision-making dynamic," Mr. Williams counsels. "If you are in practice with someone else or have a large staff, it's best to have all of the decision-making styles represented on those teams because it helps for making better decisions as a group."

When applying the decision-maker model to patient consultation communications, Mr. Williams suggests that "Charismatics" and "Followers" may be the most receptive to cosmetic surgery marketing tactics.

"Charismatics have big ideas and their own world view. They are very forward-looking and that's a telltale sign of someone who would be comfortable investing in cosmetic surgery," he says. 'Followers' are another good target market. If a 'Follower' is considering cosmetic surgery and hears positive things about a surgeon or procedure from a friend or someone else they trust then that is essentially a turn-key way to convert a consultation into a surgery," he adds.

FROM PERSUASION TO NEGOTIATION Combining an understanding of these decision-making styles with effective negotiation skills can help surgeons get the best from their relationships with employees, partners and suppliers. Louise Lemieux-Charles, Ph.D., Chair of the Department of Health Policy, Management and Evaluation (HPME), University of Toronto, explains that the most common sources of conflict are personal differences, lack of information, role incompatibility and environmental stress. Physicians are more effective, both as clinicians and managers, if they are better able to deal with those conflicts, according to Dr. Lemieux-Charles, who wrote about healthcare-related conflict management in a paper titled, "Managing Conflict Through Negotiation." She recommends that cosmetic surgeons who run large practices read the book, Difficult Conversation: How to Discuss what Matters Most. "Even when one uses the principles of negotiation, one's own emotions may still get in the way," says Dr. Lemieux-Charles, "and this book may be very helpful in suggesting ways to cope. People tell me that they keep going back to the book because every situation raises different types of issues."

For instance, she points out, "Business partners are often friends as well as partners, so it's important to commit to an understanding that the interests of the business or practice are different from those of the friendship." Including a plan for conflict resolution in the partnership contract is also a good idea. "This is especially true if the partnership is made up of very strong-willed individuals; they have to agree in advance on principles that have to be followed. Unfortunately, sometimes situations arise where the principles are not followed. In such circumstances, one might consider bringing in a mediator to assist the parties in resolving the dispute," she advises.

Dr. Lemieux-Charles recommends a method called "principled negotiation," which aims for mutual gains whenever possible and which bases results on fair standards independent of the will of either side. It's important in these negotiations to use objective criteria, she says. "Physicians generally respond to facts, data and analysis."

Regardless of the circumstance, one of the most detrimental roadblocks to leaders effectively managing conflict is avoidance. "Some bosses can't deal with confrontation, and will go to any lengths — including hiding in their office — to avoid dealing with a contentious issue," states Dr. Lemieux-Charles. "In a case like this, it often helps to bring in a conflict management coach," she recommends.

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