3 Ways to Negotiate with Your Patients and Medical Staff

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PDN-thumb1An article by Deepak Malhotra and Manu Malhotra over at Harvard Business Review has an incredibly helpful breakdown of ways in which negotiations with patients and healthcare professionals can be carried out more effectively within the hospital setting.

These skills, they argue, aren’t adequately taught in medical school or business school and can influence how numerous conflicts are dealt with, “from interdepartmental turf wars, to poorly designed agreements between hospital systems and insurance providers, to the difficulties encountered in aligning hospital goals and incentives with those of contracted physician groups.”

They observe: “In these and many other interfaces within our healthcare system, the limitation is neither incompetence nor ill intent, but rather a dearth of negotiation skills and acumen.”

While not comprehensive, their trinity of core negotiating tactics will go a long way in improving your dealings on a day-to-day basis.

First, focus on interests, not positions.

“Positions are what people want; interests are why they want it,” they write. “One of the greatest obstacles to resolving conflicts is our tendency to focus on positions—which are often irreconcilable—rather than on underlying interests, which may actually be compatible.”

Oftentimes, in turf wars, negotiations center on what each party wants, the authors contend, but what each party wants is often irreconcilable with what the other party wants. That’s why appealing to interests can often yield common ground and most important, compromise.

Second, framing matters or: “It’s not just what you say, it’s how you say it.”

There are two elements at work here, the authors write: status quo bias and loss aversion.

In the case of HIV testing, for example, studies have shown “patients may be significantly more likely to get the tests done if the choice is framed as ‘opt-out’ (the default is set at getting tested, but you have the choice to refuse) rather than ‘opt-in’ (the default is not to be tested, but you can choose to do it). The key is to understand that going against the default option presents a psychological barrier—and this knowledge can be leveraged to increase testing.”

That’s status quo bias.

On the other hand, “patients may be more likely to get the tests or treatments if the information is not presented as ‘here are the benefits of…,’ but rather as ‘here is what you stand to lose if you refuse.’”

That’s loss aversion.

“People are relatively more likely to accept risk when choices are presented as means of avoiding losses and they’re more risk-averse when the same choices are presented as opportunities for gains,” the authors write.

Finally, negotiation space or keeping “an eye on all of the parties that are relevant to this negotiation, not just those who are at the table.”

According to the article, “A negotiation strategy is more robust if it takes into account all of the relevant parties; if someone can influence the negotiation or is influenced by the negotiation, you need to take that person into account.”

They continue, “Similar issues arise in myriad contexts, such as board room decisions that go badly in practice because front-line medical professionals (doctors, nurses, etc.) are not brought into the discussion, or legislative and policy decisions that fail to take into account how the interests and perspectives of healthcare professionals and other stakeholders will support (or obstruct) the hoped-for outcomes. A decision or policy may seem brilliant (or at least the best option) when considering the interests and constraints of the people at the table, but may become a terrible idea the moment you broaden your vision to include other parties that are relevant.”

Above all, the authors state, the main question that must be answered in any negotiation is: How might we engage with others in a way that yields better outcomes and understandings?

What are some of the best negotiation tactics that you’ve discovered? What tactics or approaches would you add to this list? What negotiation tactics haven’t worked for you?

-by Pete Fernbaugh

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