Crucial Conversations and How to Have Them

Alan Edwards, Regional Director of Supply Chain, Adventist Health System, Tampa, FL

“Today’s supply chain leader faces more day to day pressure than ever before. We’re pressed to identify savings opportunities for our organizations, and more importantly to turn them into realized savings. We’re under pressure to lead key initiatives such as value analysis programs, standardization and utilization efforts, and physician alignment strategies.”

Keeping that quote in mind, let’s zero in on value analysis, standardization and utilization efforts, and physician alignment strategies. Challenging on their own, collectively they can be a bit overwhelming. In addition, each will more than likely require you to test your skills at having a crucial conversation with one or more individuals at some point. 

According to “The Book of Lists” the fear of public speaking ranks number one in the minds of the majority of people. For me that doesn’t hold true. Maybe it’s the fact that I’m an extrovert, or the fact that I fear other things more deeply. Snakes, tornadoes, scary movies, and bumpy airplane rides all rank on my “Top 5” list of fears. But holding down the #1 spot on the list would have to be “crucial conversations.” They can be paralyzing, gut-wrenching, or stressful. They can be difficult to plan and even more difficult to execute. There are times I’d rather stick a pencil in my eye than have “one of those talks.” But as a leader, it’s my responsibility to recognize when, where, and how to hold a crucial conversation; albeit a direct report, a colleague, a physician or even my boss. 

What do we know about crucial conversations? I’ve held many over the years and have found they are best held face to face. While email and telephone calls may seem like a way to “cut to the chase” and get it over with, I’ll explain later why they’re not the best choice. They’re also defined by the participants. What may seem “crucial” to you may be low risk or low priority to others. On the other hand, if the stakes are high, emotions can run even higher. And much like me, most people don’t like them. 

Unless you’re extremely fortunate, I think it’s safe to say you’ll end up facing a crucial conversation at some point in your professional journey. When you do, you should be well prepared in advance. I’d like to share how I plan for “tough talks” with physicians and executives. Hopefully you’ll be able to tailor this strategy into something for your leadership and management “tool kit.” 

When dealing with physicians, I utilize a checklist of sorts. It keeps me on track in planning and holding the conversation with the physician. Here are the key elements:

  • Acknowledge physicians are intelligent individuals driven by fact, not emotion:
  • Physicians practice “Evidence-Based Medicine”
  • Supply Chain Professionals practice “Evidence-Based Management”
  • Ask yourself the really tough questions first:
  • Do I have the <blank> to have this conversation?
  • Authority
  • Credibility
  • Personality
  • Reputation
  • Respect
  • Prepare in advance and ask more questions:
  • Why am  I having this conversation in the first place?
  • Am I the right individual to even have this conversation?
  • What is the outcome I want? For the other person?
  • What is my BATNA? (Best alternative to a negotiated agreement)
  • What am I willing to take “bottom line?”
  • Scout the other individual(s):
  • History with the organization
  • Political Clout
  • Likelihood to partner

If you find yourself on shaky ground with any of these points, it’s important to give pause and consider discussing with a peer or a mentor. You want to be fully prepared for the actual conversation, and more importantly to achieve what you set out to do.  

While having a crucial conversation with a physician can be challenging, having one with an executive in your organization can be even more taxing. Now it’s “in the family” so to speak and can have a direct impact on relationships, credibility, and long term success. Again, I use a checklist type approach in planning the conversation. A mentor I had early in my career told me, “Plan your work and work your plan!” 

  • Be a Realist:
  • Know Individual Executive Staff Members
  • Most believe in Evidence-Based Management
  • Identify your CHAMPION!
  • Learn where they stand on the “tough” issues
  • Identify potential pitfalls
  • Identify “sacred cows”
  • Understand their personality profile
  • Know what’s at stake for yourself
  • Personally
  • Professionally
  • Prepare in advance:
  • Why am I having this conversation in the first place?
  • What do I want from the executive?
  • Guidance?
  • Support?
  • Approval?
  • Action?
  • Draft a plan:
  • What’s the problem?
  • What’s the plan to fix it?
  • What do you need from the executive?

Your plan may rock on paper but remember this; “It’s all in your delivery.” When you get face to face with the individual(s) you’re holding the crucial conversation with, the way you present your position will heavily influence the response you’ll receive. Giving ample thought to the following points during the planning phase will help you position yourself for a favorable outcome.  

  • Presentation content:
  • Must be clear, concise, and accurate
  • Must include the problem, the recommendation, and the ask (i.e., the end result you want)
  • Decide on a presentation style:
  • Conversational
  • Written
  • Provides a guide to walk you through the conversation
  • Ensures important points are not omitted
  • Affords a way to revisit the conversation if questions arise, eliminates confusion

It’s my hope that “crucial conversations” are not high on your list of fears. But if they are, try using this approach to help move it down the list. In today’s healthcare environment, we’re going to need all the tools we can get our hands on to achieve success.

Alan Edwards leads the Regional Supply Chain Management efforts for Adventist Health System’s (AHS) Tampa Bay Division. He has more than 30 years of progressive achievement in managing customer oriented operations in healthcare and non-healthcare channels. His full-circle supply chain expertise includes contract administration, spend analytics, strategic sourcing, forward and reverse logistics, distribution, inventory control, warehouse operations, and value analysis. He is a seasoned team builder with the ability to bring diverse groups, such as clinical and non-clinical departments, professional and non-professional staff, and providers and suppliers, together to achieve success for all parties. Alan speaks nationally on topics such as leadership and management, strategic sourcing, marketing supply chain, value analysis, and vendor management. He has an Associate’s Degree in Logistics; a Bachelor’s Degree in Human Relations and Business and is a certified LEAN Green Belt. You can reach Alan with your questions or comments at Edwards, Alan Alan.Edwards@AHSS.ORG