Every physician leader I coach eventually reaches the same moment. They’ve done the work: gathered data, built coalitions, shared meaningful stories, aligned it to the core corporate values, used every bit of their Crucial Conversations skill set, emotionally intelligenced the nuances, and framed things in ways to be heard. It may even be an evidence-based strategy, aligned with national recommendations, while improving care and reduces worker burnout.
And still, nothing moves.
They are in the lower righthand quadrant of the energy discernment matrix (a tool I put together to help individuals discern best questions to steward their energy)
It's labeled INFLUENCE. Well now what? The influence, isn't influencing any more! They've done all the best practices. And still nothing.
The frustration and exhaustion show up when effort outpaces the level of influence in an area passionately cared for.
Once people recognize they’re in that quadrant, they usually go one of two ways. Some start arguing with reality, ruminating, pushing harder, getting louder, and blaming - reactions that drain them and ripple harm across teams. Others use the healthiest proven approaches: seeking mentorship, building coalitions, gathering data, sharing stories, reframing the conversation, and looking for the win-win-win.
Many times, those healthier approaches work to get the slow ball of change moving.
And, other times.. it doesn't.
What then?
That’s where this mini-series begins. Each week, I will offer strategies and perspectives that may help preserve energy and bring some clarity.
Redefining Success
When I’m working with someone who is in this exact spot, trying to create meaningful system change and the powers that be aren't budging - This is usually the moment when we look at how they are measuring success. It's often become tied only to organizational leadership adopting the large-scale changes.
We zoom back out to the purpose. Why do they want these changes?
What other measures or metrics could be used, and what levers to view those are within their control? This re-definition process sometimes offers practical and immediate wins. Realizing they've created community and connection. Having the local team look for collaborative system time/energy saving measures such as refill standing order protocols, pooled spaced out admin time for the Doc-of-the-Day to address the interruptions rather than sidetrack all the physicians all day every day. The details are context specific, and best developed collaboratively with all members of the team to avoid pitting front office/back office, or physician/nurses/MAs, etc.
The question stops being, ‘How do I make leadership change the system?’ and becomes ‘How do I stay aligned while they're not yet ready to change?’ Some of this has to do with where you put your focus. Only on seeing the organizational barriers to the request amps up the anger and frustration, and sometimes to the point where they see no way forward other than leaving. Focusing on where they have agency, while not denying the reality of leadership’s position, creates a bit more ease.
Then we add in one more type of metric, one that is completely uncoupled from outcomes. It is the metric of being able to look back and be proud of how you showed up, how you communicated, and how you lived your values while trying to make things better.
Sometimes success is measured by the result. Other times it is measured by the integrity of the process of grounded, calm presence. This focus often lightens the own burden a bit more.
Reflection:
If you find yourself in a similar situation, what is needed to keep you aligned and less frustrated: acceptance without endorsement, a boundary, dropping the cause for now, or something else?
Some metrics to consider, especially when outcomes aren’t as desired: integrity, clarity, groundedness, some small personal or local wins, self-respect, maintained emotional regulation, knowing you did your best. What other metrics would you add to the list?
Responses