As a rule, Keep your mouth shut works almost everywhere. Most things get worse when we speak.
However, silence can cause trouble, too. Even a pause can be deadly:
Who do you love most: me, or my sister?
Mom, was I a surprise pregnancy?
If we want safety, silence offers the best protection. It makes sense to hide and keep really quiet, when danger prowls – but not for leaders.
Doctors must lead. And leaders need to speak; precisely when everyone else is sliding down in their seats around the table.
Leaders must say something, even when there is nothing perfect to offer. Silence does nothing for a team. But we have to be careful, too: empty platitudes can come across like ‘Get Well’ cards at a funeral.
Medical Politics Thriller
If this were a spy thriller, Ontario sits at the point in the story when a bomb has just been found under the parliament buildings.
Helicopters circle. People run around screaming, and a sweating bomb tech, in safety gear, extends a shaking set of snips towards a jumble of wires.
Will he cut the blue wire…or the red one?
If you Google crisis + leadership, millions of results pop up like:
- How a Good Leader Reacts to a Crisis
- Leadership in Crisis – How to be a Leaders
- 7 Tips on How to Be a Great Leader During a Crisis
- 11 Tips to Leading During a Time of Crisis
These offer great advice. But doctors need something a bit different.
In Ontario, leaders have stepped forward from all sides: within the establishment, without, and in between. For all leaders, here are 7 tips:
Crisis Management for Doctors
1) Be cool – Lighting our hair on fire comes naturally for some. The heat and smoke releases energy and feels good, I suppose. Resist the urge, no matter how much better it makes you feel.
Everyone who looks to your reaction feels much worse when you lose control, even with an audience of one.
2) Avoid the simplistic – Us against them wins on a football field, but not with large groups. Black and white works well until kindergarten.
Oversimplifying complexity might seem to add sanity for a moment, but it never leads us out of a crisis.
3) Keep making friends – Fights during Thanksgiving dinner often leave deep, irreparable scars. Remember whom you are fighting with.
You may need to see them for your heart attack next week.
4) Forgive more – People make dozens of mistakes every hour, at their best. Under duress, we make many more. Itemized lists of all the ways other people messed up, acted poorly, or otherwise disappointed us rule out reconciliation.
Do not assume maleficence, when ignorance explains behaviour well enough.
5) Plan for the future – Force yourself to imagine life after this crisis has past. Even if things do not work out in your favour, this crisis, too, shall pass.
Your response will shape your experience of life afterwards.
6) Stop and think – Surviving the next minute blocks out all other thought in a crisis. We need more time to reflect, at the exact moment when there isn’t time to breath.
Stop. Think. Take 10 minutes to read. Pseudo-dementia comes from cognitive overload.
7) Remain positive – I think it was Dee Hock, founder and CEO of Visa, who said something like, “The times are too tough, and the outlook too dire, for negativity.”
We need hope the most, when hope seems most unreasonable.
Crisis and Silence
Trauma and crises are not all bad. Birth is traumatic, violent even. Full lives have very few dull moments. Dreams of peace and quiet come true only for the most heavily sedated, on locked wards.
The excitement in Ontario will pass, eventually. We will go back to working together, sharing patients, and finding ways to work with others to improve our healthcare system. But during a crisis, many people find it safer to clam up and keep silent.
We need people to offer reasons for hope, no matter which direction this turns. Silence is not an option in crisis management.
Photo credit: The Hurt Locker
The pressure felt by doctors prior to this tPSA has intensified by the OMA representing the value of this agreement with positive bias, when it favours the MOH over the members
This amplification of what we have received has propelled the petition movement to curtail the alliance between the MOH and OMA, which through CoManagement we will be Coerced without a voice. The seismic shift in feelings had to happen under the extra pressure from the organization meant to represent and protect us. The OMA mistakenly believes this is an agreement in our best interest. I have yet to meet a doctor who believes in it.
The OMA can best represent the membership by transmitting a rejection from the membership to the MOH and never agree to present an agreement by ratifying at board level in the future.
The OMA is telling us to think of all the pros and cons, but only presents the pros in their press releases. The MOH and OMA initial press releases had a spin for the public and doctors respectively. The average member can now see through manipulation and micromanagement.
Thank you Shawn for encouraging us to “dig deep”. This is refreshing an emancipating.
Prior to this we were a herd easily led into the same pen. We are now independent thinking individuals and we can respect each others views. However I have never seen such an overwhelming rejection of a PSA. This is no confidence vote in the MOH and the OMA in endorsing such a toxic agreement. We have lost our referendum on saying No , as a by product of the petition. However we are collectively hypervigilant that further manipulation and spin will take place prior to a membership convention. We need to scrap this agreement and engage a negotiating team that carefully analyzes our needs and that of our patients. We should not be forced to vote on an agreement that was sent to us with ratification which contaminates any objective analysis. The fact the MOH demanded it be ratified before being sent is a fundamental flaw. The OMA is having it’s Bernie Sanders movement from within and we can have hope again and Shawn you have helped define, who we are and who we can become. Thanks! Let us never become silent again!
Thanks Sean,
This contract has forced us all to go far beyond where we ever wanted to go before. Stretch is a good thing. But even in a more typical negotiation cycle, where members were fully engaged from the start, this tPSA represents a huge stretch in a very short time.
Having said that, I am certain that doctors can find all the good and bad things about this deal. This decision on the next phase of healthcare rests with doctors, as it should.
I just hope doctors take the time to digest what the contract means in all its implications.
Best regards
Shawn
Einstein said that doing the same thing over and over again and expecting a different result is the definition of madness. This contract isn’t so much of a stretch as it is the same old same old only worse. It is the construct of inertia, and unwillingness to change despite overwhelming evidence that the old way isn’t working. We need to keep our eyes on what we want and not what we are being offered. Screaming at each other isn’t productive but crossing your arms and saying no to all change isn’t productive either. We have to come together and shape a new future for ourselves that isn’t defined by government and short-term political expediency. We have to realize that we are perhaps the most powerful group of people outside of government and in some ways more powerful because after the next election, we’ll still be here! Lets not vilify OMA too much here, they think they are doing the right thing even if its the same old thing. OMA central is going to have to bend or it will break. We need more than a new contract, we need a new deal.
I really like how you said this, Ernest: “We have to come together and shape a new future for ourselves that isn’t defined by government and short-term political expediency.” Well said, indeed.
Thank you for sharing such a thoughtful and balanced comment. I hope readers take a moment to see it!
Cheers
Shawn