In each team there is always a leader or head of the team. In medical practice, the person that heads the team is the consultant. In the hospital setting each department has a head of department, and each firm has a lead consultant, with the head of the department also being the head of a firm. Similarly in the primary care setting, there is always someone who heads the team.
Consultants play a crucial role in team dynamics, as how the team operates is usually a direct reflection of the type of leader they have. This means that consultants are in a unique position to effect positive change in how a team operates and how its members work together and interact with each other.
Below are a few ways consultants can help to improve their team’s dynamics. This is important as building rapport, encouraging respect and having synergy is crucial to a team’s efficiency and its members quality of life in (and often outside of) the workplace.
Lead from the Front
Leading by example is probably the most obvious way to improve a team. Hold members to a standard but also ensure you also hold yourself accountable as well. ‘Do as I say and not as I do’ is not the mindset we want to uphold, as integrity in medicine is a core value. If your subordinates see you as an example of what is right, and what should be done then they are more likely to follow suit.
Leading from the front transcends clinical medicine, it also includes soft skills. How do you speak to your juniors? How do you challenge them? Do you show them respect? You set the tone of what is acceptable and what is unacceptable- and once your standard isn’t met you must keep your team (and yourself) accountable.
Ex 1. If you don’t tolerate lateness from your juniors, when you yourself are late- what ever the circumstances- call ahead and apologise for tardiness just as how you would expect them to.
Ex 2. When speaking to your juniors you refrain from correcting them in a destructive manner, you have been informed that a member of your team is moving away from this standard- you don’t let it pass, but address it and remind that member of the standard you want to uphold for your team.
2. Clarify roles and expectations
Medicine is an apprenticeship, we have been hearing this from medical school days, this means that each person will likely get a different experience. It is good practice to clarify with your team what you expect from them and what are their roles. This eliminates confusion and frustration- especially if someone feels they’re being asked to perform tasks unfairly or above their level of expertise. This also avoids the feeling that work is being unfairly distributed. These don’t all have to be pointed and specific but fall under general principles of practice.
At each level of seniority, roles and expectations are different but all interconnected and are made to improve the efficiency and functional capacity of the team.
Ex 1. The most junior staff is expected to be supervised by both you and more senior members of the team, this is to facilitate learning and safety of the patient.
Ex 2. One of the roles of the most junior staff is to collect results and do ward work such as taking blood, however, it is expected that if these tasks are overwhelming or difficult more senior staff will be enlisted to help.
3. Create a safe space for discussions and feedback- this also includes complaints
Your team should be a safe space for questions, suggestions, challenges on management and yes- feedback on peers… this also includes you! Each team has persons of varying skills and knowledge levels. One of the best ways to learn is on the job and around your patients. Therefore, members need to feel comfortable to ask questions on management, suggest course of actions and yes challenge their seniors without fear of being reprimanded.
Since we are human, conflicts will arise, and therefore systems need to be put in place where complaints can be made and addressed. These complaints should not cause permanent rifts, as the aim is to grow and improve upon the professional relationship of the team. Conflict management and resolution is a crucial task as a consultant.
Ex 1. You have ordered an antibiotic for a patient, but your intern does not believe that this is the appropriate management based on the most recent guidelines. In this situation you want to have created and facilitated a space where even your most junior staff feels comfortable enough to challenge you in a respectful manner and will not bruise yours or anyone else’s ego. Same as how if they suggested the incorrect antibiotic, your correction of them would be constructive without destructive and unnecessary criticism.
Ex 2. One of your juniors has spoken to you as they are unhappy with how they’re being treated by another person on the team. They feel constantly disrespected and put down by this person. Is your response to brush it off and by extension condone it or take appropriate steps of redress, whether by seeking clarity in order to address and possibly correct that behaviour privately while holding them accountable or even seek more serious sanctions if needs be.
4. Support your team
Your teams needs to feel as though you are a part of the team and that if they need you to stand up for them and support them you will. A team that cannot trust that its leader will have their best interest at heart and be an advocate for them to other administrators will not be able to function optimally. As they will constantly feel anxious and afraid to make mistakes because they know they will be “thrown under the bus” by someone expected to lead, guide and support them.
This is also obvious to other persons who may have to interact with your team. If they feel that there will be no repercussions if they disrespect the authority of your team members your team will feel as though they are left at sea to well- fend for themselves.
Ex 1. Members of your team are trying to mobilise other workers to perform a task and are faced with difficulty- do you tell them you just want the task done, the how isn’t important or do you use your power of authority to hold others accountable.
Ex 2. A member of your team has not been functioning well, they are always tired, forgetful and have started to look disheveled at work. Do you ignore these signs and tell them the work needs to be done, or do you take them aside, inquire what is wrong, validate their feelings and problems and encourage them to seek help- offering to give days off so they may do this.
5. Encourage Building Rapport
Rapport is important because it makes team members feel connected to and respected by one another. This is not something that can be forced, but spaces should be created for organic development. People can tell when things are done- just because- so it’s necessary to be genuine and invested in your team and its members.
This is a great time to enlist your juniors, often rapport is easily built when persons feel safe, respected and supported by their team and especially their seniors. Make time for lighter moments such as birthday celebrations and activities that encourage unity, such dressing following a particular theme. Take the time to get to know your team along with the various nuances they may have, all within a professional scope. These social aspects of team building actually impacts efficiency and synergy and is more likely to get the best out of your team.
Ex 1. One of the residents is having a birthday soon, so you and your team decide it would be nice to have a special lunch to show this person how important they are to the team and that they matter to you all beyond a functional capacity.
Ex 2. Light moments such as on ward rounds are not met with scolding, but are allowed to happen naturally while still focused and professional.
Help your team
Consultants are in a position of authority where they can mobilise resources making it easier to complete tasks. When your team is faced with difficulty achieving the outcome you desire, look for ways your power can be leveraged. This shows that you see yourself not just as the head of the team, but also a part of the team.
Ex 1. A patient has not been able to get a particular study done, your juniors have exhausted all channels available to them. You leverage your authority and mobilise the necessary resources for a smoother and swifter process.
Ex 2. Your juniors are having an issue with a recent change in their duty schedule. They believe the new schedule is unfair and does not allow them to have a proper quality of life. You listen to their suggestions and bring this up with the consultant in charge of this, advocating for your juniors along with presenting realistic solutions.
For the consultants who may come across this article, do not feel singled out. Many of your are already doing some of the things I mentioned above and just need to continue to build on your foundation.
Juniors, this article is also useful for you, as you too occupy senior roles and can use these same methods to better your team.
A high functioning and efficient team has a lot to do with team dynamics- more than I could say in one article! I would love to hear your tips and advice and how they have benefitted your team!
Samantha C. Johnson