3 negotiation strategies for hospitals, physicians

Hospitals and physicians lack the negotiation skills needed to resolve conflicts about patient care decisions, interdepartmental turf wars, insurance agreements, and organizational goals and incentives, according to a blog post published in the Harvard Business Review.

Medical schools don't teach these skills but they are necessary to produce better patient outcomes and quality care, write authors Deepak Malhotra, Eli Goldstone professor of business administration, and Manu Malhotra, M.D., medical director of the emergency department at Henry Ford Hospital in Detroit.

They suggest doctors and hospital administrators brush up on these three skills before their next negotiation session:

1. Stay focused on your interests--not positions. A big obstacle to resolving conflicts is people take a stand on positions--what people want, instead of why they want it. Therefore, think about what is driving the other person's behavior. The Malhotras use the example of a trauma surgeon and emergency physician at a Level I Trauma Center, who both want to oversee trauma resuscitations. Since only one person can be in charge, consider each person's underlying interest. The trauma surgeon may value his or her role as "captain of the ship," a requirement for Level One certification by the American College of Surgeons. The ED physician, on the other hand, may want to preserve the educational experience for his or her residents. The solution? A compromise that names the trauma surgeon as the captain of the ship and allows the ED residents to lead the resuscitations and do the procedures.

2. Think about how you communicate your message. Communication skills are essential to collaboration and compliance, they write. People are more likely to accept risk (such as a particular treatment or drug) when the discussion is framed as a way to avoid a loss. For example, they write, consider the case of a hospital administrator who has to choose between two growth initiatives: a new clinic in a growing area or a merger with a neighboring hospital. Although both have the same anticipated level of success, the merger has a higher risk. The new clinic may be less risky, but if the administrator thinks about how the hospital margins are shrinking, he or she may consider a merger to avoid further erosion.

3. Consider all parties, not only the ones at the negotiation table. All the people at the table may throw their support behind a particular policy, but often board room decisions take a wrong turn when they announce the new policy to the healthcare professionals that must follow it. Robust strategies take all the relevant parties into account and include them in the discussion.

For more:
- read the blog post

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