A) You have a car and you want to sell it for anything more than $12,000. If you make more money than the other team, your team wins.
B) You need a car and you’re willing to buy it for anything less than $14,000. If you make more money than the other team, your team wins.
These instructions were given separately to two groups of junior doctors and they were asked to work between themselves to come up with a negotiation strategy and were then given a series of three timed negotiation sessions. Neither group was aware of the other group’s financial goals. This is the situation I found myself in Workshop 3 of the LEAP program, a leadership program for junior doctors in NSW supported by the Health Education and Training Institute (HETI).
The negotiations were filmed and the representatives played the traditional cat and mouse game of buyer and seller. I was on the buying team and we opened with an offer of $10,000 and the seller refused and asked for $16,000, and then we returned with an offer of $11,000…
Of course we were using jelly beans instead of money, and a whole range of unfunded tactics were introduced by the seller (free servicing, floor mats, free fuel) to sweeten the deal but ultimately neither of us got what we wanted and went home empty-handed. Our collective desire to win and refusal to compromise (which are often valuable attributes) had left us with no deal.
At the end of the simulation we were told about the price the other group would have settled for – we were left with a sense of disappointment, frustration, and a strong lesson on negotiation that many of us will never forget. Negotiation takes humility, courage, empathy and a genuine desire to reach a win-win solution.
The skills of negotiating apply to the micro environment of the junior doctor (trying to negotiate an appropriate time for the CT scan, trying to convince the plastics registrar to have a look at the wound infection, asking another resident to cover for you), but also the macro environment of all doctors. How can we negotiate with the administration for more support for intern teaching? How to convince senior doctors to support a project to improve the indigenous health gap? How about funds from the hospital executive to trial a pilot project to improve the experience of NESB patients in hospital?
Negotiation is about finding what the other party wants, what we want ourselves and trying to find common ground.
This is one example of the many learning opportunities that were part of the LEAP program. It is run over five workshops (spread over ten days) and runs through a range of topics (delivered in a variety of imaginative ways!) including:
A core part of the program is the opportunity to work on a project with other participants, and is a wonderful simulated environment to practice the difficult skills of being assertive, being a leader and also being a follower, dealing with personality clashes and time management.
The program costs $1,500 (heavily subsidised by HETI), is run by an enthusiastic group of consultants, and I would highly recommend the program for junior doctors aspiring for any specialty. The program will help you clarify your own vision, improve your own understanding of the NSW Health system, and give you the tools (social, intellectual, interpersonal) to be able to implement and lead change in your organisation and specialty.
Hopefully at the end of the program you will be better placed to influence the way we deliver and manage health and disease in our society. Our health system is wonderful and thousands of people benefit from it every day. But we can make it safer, more efficient and more equitable – and one of the most important ways this can happen is through doctors who are able to:
These grand ideas might sound ludicrous as we wade through discharge letters, rewriting medication charts and taking bloods – “As if I can make a difference to the health system – I have to discharge three people today and take notes on the ward round!” But over the year you meet a range of junior doctors who have been through the LEAP program, imagined/planned/implemented a vision, and as a result, have improved the system in a tangible way.
You’re reminded that people just like you have done extraordinary things and made an impact on vital areas of healthcare including junior doctor education, patient safety or hospital efficiency. And perhaps this is the most beneficial aspect of the LEAP program – the constant reminder of the fact that you are the future of the health system, that you’re not just a secretary who can insert cannulas and order tests, and that if you put your mind to it, you will make a positive difference to the health system.
Applications for the 2015 LEAP program are now open for NSW doctors. More information can be found on: