{"id":31672,"date":"2020-04-08T05:00:08","date_gmt":"2020-04-07T21:00:08","guid":{"rendered":"https:\/\/thinking.physio\/?p=31672"},"modified":"2020-05-06T15:15:03","modified_gmt":"2020-05-06T07:15:03","slug":"negotiation-is-part-of-clinical-practice-heres-how-to-get-better-at-it","status":"publish","type":"post","link":"https:\/\/thinking.physio\/negotiation-is-part-of-clinical-practice-heres-how-to-get-better-at-it\/","title":{"rendered":"Negotiation Is Part Of Clinical Practice: Here\u2019s How To Get Better At It"},"content":{"rendered":"\n
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Effective negotiation allows both parties to achieve goals whilst maintaining the ability to make decisions freely<\/figcaption><\/figure><\/div>\n\n\n\n

It\u2019s fascinating how often you have to negotiate in life. The reality is that negotiation is a critical part of clinical practice. <\/p>\n\n\n\n

I recently read \u201cNever Split the Difference\u201d<\/a><\/em> by expert FBI negotiator Chris Voss because. It was an extremely interesting book to read. By the end I realised that his concepts in negotiating with terrorists and business owners would be invaluable for clinicians and clinic owners when working with staff and patients alike. <\/p>\n\n\n\n

Negotiations permeate through every facet of our lives. Even though the person you are talking to is not a terrorist, the thinking process in achieving a desired result is the same.<\/p>\n\n\n\n

Below are some useful techniques Voss laid out in his book. I also cover WHY<\/em><\/strong> they work. Anyone can use these techniques during any negotiation.<\/p>\n\n\n\n

Two key things before we address strategies<\/strong><\/h4>\n\n\n\n

First, what is a negotiation?<\/strong><\/p>\n\n\n\n

Negotiation<\/a> as a situation where you and another party need to get something done, but the terms of that \u201csomething\u201d have not been defined. That\u2019s where the negotiation comes in.<\/p>\n\n\n\n

Why do we negotiate?<\/strong><\/p>\n\n\n\n

In clinical practice, actions need to be taken and progress needs to be made to reach an outcome your patient wants. People have different views, beliefs and motives, and of course, different incentives on how they want to do things. <\/p>\n\n\n\n

There are times when you might have an idea on how things should be done to get clinical improvement, but your patient might have other ideas. <\/p>\n\n\n\n

Effective negotiation allows both parties to achieve goals whilst maintaining the<\/em> <\/em><\/strong>ability to make decisions freely<\/em>.<\/strong><\/p>\n\n\n\n

Emotions<\/strong> Drive Decisions<\/h4>\n\n\n\n

Almost all of us make decisions based off of emotion. Often we are convincing ourselves that we are making a \u201crational\u201d choice to cover the fact that we don\u2019t think rationally. <\/p>\n\n\n\n

As Nobel Prize winning psychologist Daniel Kahneman quips in his book \u201c<\/a>Thinking Fast and Slow\u201d<\/a>:<\/em> <\/p>\n\n\n\n

\u201cWe are blind to our own blindness.\u201d<\/em><\/p>\n\n\n\n

So what\u2019s the point here? <\/p>\n\n\n\n

You can\u2019t win a negotiation by trying to appeal with reason<\/em>. By doing this, you immediately put yourself at a disadvantage. <\/p>\n\n\n\n

How often do clinicians try to reason with their patients? I certainly did! And I can tell you from experience that my reasoning rarely made long term changes to behaviour in chronic care management.<\/p>\n\n\n\n

As Voss says, \u201cMost of us enter verbal combat unlikely to persuade anyone of anything because we only know and care about our own goals and perspective.\u201d<\/em><\/p>\n\n\n\n

How do you find out about another\u2019s goals and perspective<\/a>? UNDERSTAND THE OTHER PERSON FIRST<\/strong>. <\/p>\n\n\n\n

Here\u2019s Voss:<\/p>\n\n\n\n

\u201cWork to understand the other side\u2019s \u201c<\/em>religion<\/em><\/strong>.\u201d Digging into world-views inherently implies moving beyond the negotiating table and into the life, emotional and otherwise, of your counterpart.\u201d<\/em><\/p>\n\n\n\n

To create the right frame for anything to get done, you have to first understand the emotions of the other person, and appeal to those emotions. <\/p>\n\n\n\n

Here are a few strategies he lays out to get started creating empathy and understanding. None of these use logic.<\/p>\n\n\n\n

Strategy 1: Mirroring<\/strong><\/h4>\n\n\n\n

Mirroring is a simple technique where you mirror the person you are talking to by repeating the last 3 words. Or you repeat the most critical pieces of information, that they just said.<\/p>\n\n\n\n

For example, if someone says, \u201cI\u2019m having a really bad day. The pain just hasn\u2019t let up.\u201d  <\/em>A simple mirror looks like, \u201chmm, the pain hasn\u2019t let up?\u201d <\/em><\/p>\n\n\n\n

By ending the mirroring with an upward inflection in your tone, you make it a question. This allows the patient to give you more information.<\/p>\n\n\n\n

You can choose to mirror using a downward inflection in your tone. This will make the mirror a statement and could be followed by “Tell me more”.<\/p>\n\n\n\n

Mirroring builds rapport with your patient by showing that you are listening and have heard what they had to say. Everyone wants to feel listened to. They are more likely to continue with their thoughts for you to better understand their situation.<\/p>\n\n\n\n

Strategy 2: Labelling<\/strong><\/h4>\n\n\n\n

Labelling refers to calling out the emotion of the other person\/patient. It lays the emotion out on the table in order to discuss and move the conversation along productively. While it seems combative on the surface, Voss describes the usefulness of labelling:<\/p>\n\n\n\n

\u201cWe employed our tactical empathy by recognising and then verbalising the predictable emotions of the situation. We didn\u2019t just put ourselves in the fugitives\u2019 shoes. We spotted their feelings, turned them into words, and then very calmly and respectfully repeated their emotions back to them. In a negotiation, that\u2019s called labelling.\u201d<\/em><\/p>\n\n\n\n

Putting a label on an emotion gives your patient a chance to better explain themselves<\/em>. Furthermore it helps you better understand their perspective. <\/p>\n\n\n\n

Instead of trying to get commitment when you sense resistance, try using some counterintuitive labels such as these:<\/p>\n\n\n\n