At the request of her staff, Dr. Sara Teal, medical director, negotiated change in her work schedule. After making the case and getting approval from administration, she shared the good news with staff, only to be met with resistance. Frustrated and confused, she asked, ”What could I have done to avoid resistance?”

Implementing change is especially challenging now, when many forces reshaping healthcare leave physicians feeling powerless.

Myth: People naturally resist change

A common belief is that resistance is the natural human response to change. However, not all change provokes resistance. We seek change that we choose freely.

Reason For Resistance

Based on over three decades of research, human development expert, T. Falcon Napier, reports that what people resist is loss of control. The sense that you could lose control of what is important creates tension. Of three criteria – logic, feasibility, and level of tension – that must be met before change occurs, level of tension is most critical. Too little tension provides no motivation to change. Too much tension results in feeling overwhelmed.

Often, we focus on logical and feasible cases for making a change, instead of exploring tension experienced by individuals involved. The change implemented by Dr. Teal was both logical and feasible. Resistance occurred due to staff having tension about change. People who resist change have something else they know, care about, or enjoy.

Symptoms Of Resistance

Anger and complaints are obvious expressions of resistance. Other symptoms of resistance include:

  • Verbal agreement, despite limited follow-through
  • Slow progress
  • Excuses for lack of progress

Position Power vs. Personal Power

Viewing resistance as healthy, natural, and a useful part of the change process is key to addressing resistance constructively. Dr. Teal could have used the authority of her position to push the schedule change through. Instead, she recognized that it would be faster and better for her to acknowledge individual perspectives and concerns and for the team to rely on trust and respect. Her goal was to leave everyone feeling more in control of the change, rather than feeling coerced, which would have lead to more resistance.

Resistance can be mild or major, depending on how disruptive the change feels to an individual. One of Dr. Teal’s team, Dr. Jones, clearly was upset by the proposed change. Instead of one more group meeting to review the facts, Dr. Teal met personally with the reluctant physician. She focused on understanding, acknowledging, and addressing his concerns.

Strategies For Addressing Resistance

  • Start with yourself. Dr. Teal explored self-honesty first on how she felt about the change, to avoid conveying unintended non-verbal messages.
  • Acknowledge that, with every change, even good ones, a loss occurs.
  • Listen to understand, not just to respond. Listening without judgment acknowledges validity of another’s perspective, even if you don’t agree.
  • Create a safe space for concerns to be expressed, by listening and acknowledging emotions described, not merely the words spoken. Being comfortable with strong feelings is required!

My recommendation to Dr. Teal to be proactive about addressing resistance was to go beyond the logical, feasible case. In the future, she will explore physical and emotional components of a proposed change. Taking the time to listen and asking good questions when resistance is encountered are investments that pay off in the long run.

Deborah Munhoz coaches physician leaders to have greater influence and job satisfaction. For questions or comments, contact Deborah here.

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