Health Services Research & Policy ■ Clinical Practice Management ■ Training & Education ■ Leadership
Health Services Research & Policy ■ Clinical Practice Management ■ Training & Education ■ Leadership
Health Services Research & Policy
■ Clinical Practice Management
■ Training & Education ■ Leadership

Hem, Haw, Sniff, Scurry: Moving Cheese, Managing Change

Radiology teams can look within for change leaders instead of hiring certificate-armed "expert" consultants.

 In a recent JACR article, Richard Duszak, MD, reminds us of Spencer Johnson's best-selling 1998 murine business-culture allegory "Who Moved My Cheese?" The book details four different ways to react to a moved piece of cheese. The cheese is a metaphor for change. Leading the pro-change charge are those who sniff (they're always on the lookout for change and embrace new situations) and those who scurry (they react to change quickly and positively). Lagging behind are those who hem (they dig in and resist change) and those who haw (they will slowly accept and adapt to change). 

Change happens, we learn, whether we want it to or not. Better to be proactive about it. When your cheese is moved, inertia is not an option.

Change is good, right? In a January 2013 Dilbert comic strip, Pointy-Hair Boss remarks during a meeting, "Do not fear change because change is good." Dilbert retorts, "Actually studies show that any big changes in a person's life vastly increase the odds of sickness and death." "Are you trying to kill us?" asks Wally. Dilbert grabs his right arm with his left in fake surprise, "I can't feel my arm!" Dilbert is clearly exaggerating, but he's onto something. 

Change happens; it's unavoidable. Change is also stressful. If we acknowledge those two truths, then anticipating change and adapting to change may reduce stressful feelings. However, all the positive thinking and motivational fables in the world may not be enough to overcome the tsunami of change that is underway today in medicine. That's where leadership comes in. 

Change leaders can make the difference in whether or not radiology team members feel secure and confident that they can successfully ride the waves of change — whether they are gut-clenching Banzai-Pipeline monsters or small but numerous swells.

Change leadership certification programs have proliferated in recent years. Armed with certificates from programs sometimes lasting no more than four days, armies of change leaders are streaming out of leadership mills to help you embrace and implement change. So every radiology department should hire a certified change leader to help navigate the uncharted waters of current and upcoming workplace changes, right? 

Maybe not. H. Benjamin Harvey, MD, JD, from Massachusetts General Hospital, this week's Radiology Firing Line podcast guest, tells host C. Matthew Hawkins, MD, that radiology departments have so much existing expertise about internal processes, workflow, and personnel, that just a set of really good tools could be transformational.

Change leaders — the sniffers and the scurriers — need to be trusted to win over the hemmers and hawers. A certificate in change management shouldn't necessarily engender trust. But someone who is already trusted as a radiology leader, as a quality expert, and as a team builder has the insider's view of the complexity of a department, its needs, and its challenges. With buy-in from the rest of the team, such a home-grown leader can train everyone to be an integral part of making change happen more smoothly and less stressfully.

Identify your change leaders, empower them with robust tools, and give them the buy-in they need. Once that is done, even your most skeptical hemmers and hawers might say, "Go ahead, move my cheese. I'm ready."

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Saturday, 24 August 2019

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