How can you become a change agent in your medical practice?

The other day I was catching up with a friend of mine. He was telling me that he was a bit frustrated at work because the people he works with aren’t as efficient as he’d like them to be. He went on to say that management wasn’t open to making improvements, listen to new ideas or open to change.

I told him that he was describing a classic leadership (you don’t have to be in charge to be a leader) problem; which is, getting people to change.

It seems that whether you’re on the employee side or the employer, fundamentally, if you’re a leader, you’re always in this predicament.

I shared with him that despite running our own business, we still face the “change” challenge; except this time around, it comes directly from our employees. They resist change sometimes.

On my way home, I thought about how I could help my friend as well as formulate some of the things I could also do, to overcome this issue of people resisting change.

When I got home, I sent him a message with these nine points:

1) Garner support. One has to find it somewhere. One can rarely promote change without support.

2) Appoint supporters. One can’t do it all. Getting a few people to take the lead on certain projects from the pool of those that support your cause should be explored. This will also give people ownership and responsibility. Oh, and accountability as well.

3) Start small. 20 different “improvements” may be too much to handle. Especially when motivation isn’t that high to begin with. Pick a small improvement and work your way up.

4) Document success. Document the successes you have with your “small” improvement projects. If you can show how much you made things better, you’ll be able to make a better case to promote and actually make change.

5) Don’t depict the promise land, yet. A leader that I respect a lot once told me that a leader’s role is to move people from here… to there. So what leaders often do, is, depict how wonderful “there” will be once they get there (often described as selling the vision). But people/staff usually like it “here,” despite the wonderful things “change” or “there” may bring. People prefer to stay comfortable with what they know. So what do you do? It is not always effective to show how great “there” will be, but rather, show how bad it will be if one stays “here.”

6) Staff have answers. A couple of weeks ago I asked our staff, if you were in charge, what would be the one thing you’d change in our office? Surprisingly, some of the suggestions were actually easy to implement. For example, one MA said that by rearranging nurse visits on the schedule on Wed and Sat (when there is only one doc and half the staff) we could improve patient flow.  The front desk agreed, decided on where to put the RN visits on the schedule and done.

There are several lessons in this little story for me, but for our topic today the point for me is, there are many improvements that can be made without an “executive” committee being involved.

7) Trials. If  you are almost certain your way is better, ask the person you are trying to influence to give you a chance to try your method out. If it doesn’t work, no harm done. If it does, then you’ll be able to make a better case for your changes.

8) Asking for forgiveness is better than asking for permission. My approach has always been, if I’m going to get in trouble, I’d rather it be for doing something rather than for not doing anything. This means, be a leader and be like Nike, Just Do It!

9) What can you change in yourself? Also think about some of the things you can change in your actions and your behaviors.  Often, we think about how we can change others, but rarely do we think about things one can change in ourselves that garners the change we want in others.

What other things would you add to help make “change” happen in your organization?


  1. Great post! This is something that all management should take in account.
    I have only worked in 1 company (Healthcare) in this country for the past 8 years and I found that the main problem has always been poor management. The talent I found was incredible; I learned from them, but I also learned how not to manage a business. I moved on and now I am in a more open-minded company, where employees are taken in account and their opinions are respected.
    A manager will always find resistance, that is the human nature: Resistance to change. It is a challenge, but I think it is possible to make that change happen, as you said.