Episode 14 – Help! My senior partner is a jerk, with Dr Jamie Wyllie

In this episode, Rachel is joined by Dr Jamie Wyllie co-author and presenter of the Red Whale Lead. Manage. Thrive! Course.

This is an ‘Ask the Frog’ episode where we chat about a question that we are often asked by GPs – how do I influence someone who is set in their ways, resistant to change and autocratic? We discuss the need to get on the same branch as them, to recognise what their thoughts and feelings are and ultimately, understand what their needs are.

We discuss what it is to be a partner (not just in the legal sense of the word) which includes creating a shared purpose, the right to say no, joint accountability and absolute honesty – something that, if we are honest, very few of us really achieve. We talk about ways to improve relationships in the team and the fact that only thing we have full control of is ourselves.

Please click here for a free download of cringe-free activities to develop your team – for use in partnership meetings and away days.

Rachel Morris: (00:00)
Welcome to episode 14 of you are not a frog: Help. My senior partner’s a jerk.

Rachel Morris: (00:08)
Welcome to You are not a frog the podcast for GPs, hospital doctors, and other busy people in high stress jobs. Working in today’s high stress environment, you may feel like a frog in boiling water. Things have heated up so slowly that you might not have noticed the extra long days becoming the norm. You’ve got used to feeling constantly busy and are often one crisis away from not coping. Let’s face it, frogs only have two choices: to stay in the pan and get boiled alive or to hop out and leave. But you are not a frog and that’s where this podcast comes in. You have many more choices than you think you do. There are simple changes that you can make which will make a huge difference to your stress levels and help you enjoy life again. I’m your host Dr Rachel Morris, GPs and executive coach and specialist in resilience at work. I’ll be talking to friends, colleagues, and experts, all who have an interesting take on this so that together we can take back control to survive and really thrive in our work and lives.

Rachel Morris: (01:14)
I’d like to tell you about our new CPD forms. If you want to learn while you listen and claim CPD points, then go to the link in the show notes and sign up to receive our fully downloadable podcast CPD forms. Each one is populated with show notes and links so that you can listen, reflect, and then note down what you’re going to do. A quick, easy, and enjoyable way to do your CPD. In this episode I chat with Dr Jamie Wyllie. He’s a portfolio GP from near great Yarmouth and he’s a former director of clinical transformation. He also has a masters in leadership and health improvement from Ashridge. He’s a fellow lead, manage, thrive presenter and he coauthored the course. I thought you’d be really interested to hear some of his views about partnership and about generally getting along in a practice.

Rachel Morris: (01:58)
So Jamie, it’s great to have you on the podcast today. Thank you for joining me, and first of all, I just want to ask , what is that in front of your microphone?

Jamie Wyllie: (02:06)
Now it’s a thing called a pop screen. Um, uh, or a, you may recognise it as my wife’s tights, but it prevents those nasty little pops and bangs when you p and b.

Rachel Morris: (02:17)
I don’t know, it just doesn’t look like any pop screen I’ve ever seen before.

Jamie Wyllie: (02:20)
That’s because I made it at half past 11 last night.

Rachel Morris: (02:22)
That is –

Jamie Wyllie: (02:23)
It’s amazing what you can do with a coat hanger and a pair of old tights.

Rachel Morris: (02:27)
That is commitment to a podcast. So you know, we’ve got, we’ve got surgeons, you know, saving people’s lives with coat hangers on airplanes and we’ve got Jamie…

Jamie Wyllie: (02:35)
Saving pops in podcasts.

Rachel Morris: (02:39)
Yeah.

Jamie Wyllie: (02:39)
With a coathanger.

Rachel Morris: (02:42)
Brilliant. So I’ve, I’ve got Jamie on today because we would like to consider a few things that we’re asked. We’re often asked lots of questions as we go around the country when we do our lead, manage, thrive course. So Jamie is one of my coauthors, copresenters, on the lead, manage, thrive course and I absolutely love doing the course with him. You know, he is so grounded in management leadership theory and always sort of has a really interesting take on stuff. So I wanted to ask him a question that we are asked quite a lot by people and it’s a, uh, a question about, about practice. So let me just read out the question and maybe we’ll have a discussion about it if that’s okay Jamie.

Jamie Wyllie: (03:21)
Fire away.

Rachel Morris: (03:21)
So, dear you are not a frog, I’ve recently joined a practice as a partner where I’ve been a salary GP for the last five years. I love the practice. Everyone’s friendly and the other four partners are great. Mostly. My problem is that the senior partner has become more and more stuck in his ways. He set up the practice 30 years ago and it’s gradually become larger. We now have around 16,000 patients. The workload seems to be going up exponentially and we’re all staying later and later. Whenever I tried to bring this up in a meeting, for example, suggesting getting more GP sessions or trying some new schemes, for example, doc man, he shuts the discussions down. When I was salaried, I noticed he could be a bit autocratic, but it seems to have got 10 times worse. The other partners known about it, but no one seems prepared to stand up to him. He’s due to retire in three years and seems obsessed with maintaining the status quo until then. I’m at my wits end and don’t know what I can do differently. So it’s an awful lot in that I think.

Jamie Wyllie: (04:23)
Yeah.

Rachel Morris: (04:23)
And it’s certainly a common complaint that, you know, I’ve heard from people. Have you had people having problems like this?

Jamie Wyllie: (04:30)
Yeah, absolutely. It feels very much like the sort of thing that one experiences kind of day to day and talking to colleagues around the area, it’s a very recognisable situation, isn’t it?

Rachel Morris: (04:39)
Mm. So, so Jamie, what would you say to the person asking that? What would you, you know, where would you even start?

Jamie Wyllie: (04:49)
Um, I mean obviously face to face with people. I think when we’d want to start with empathy wouldn’t you? You’d want to recognise this is difficult. It’s hard. You’ve taken a step into partnership and it feels like, hang on. As soon as you’ve done that, things are starting to go wrong. And it’s all about this. Yeah. The senior partner, um, yeah, we feel for that person, don’t we? Um, that’s hard. And I think there’s a, there’s a lot of great content on the, uh, on the podcast already that should be helping that person to, uh, to engage with their own feelings and to self manage. And that’s really, really important because I think that the place I’d start with this is to recognise that the way you’ve set this problem up articulates the problem as entirely located in the senior partner. But the only person we really have control over is ourselves. Um, and so this, there’s something in there just about, uh, we’ll, you know, in a moment we’re going to get into that discussion aren’t we about where the senior partner is coming from and what’s going on and what can you do and how can you move it along. But the first place to recognise, the first thing to recognise the place to start is that you can’t change your senior partner. You can only change yourself.

Rachel Morris: (06:00)
It’s interesting, isn’t it? Because I think, you know, this person only noticed this when they became a partner and this, this seems to happen a lot, you know, you know, this person was really fine and then suddenly we joined them as a partner and suddenly they’re awful. And obviously probably that person hasn’t changed at all. But what’s changed is your, your own perception of what’s going on probably.

Jamie Wyllie: (06:19)
And I think the step into partnership changes relationship doesn’t it? Um, I think, uh, having been a partner for for some years, um, and then stepped out of partnership and then stepped back into being a salaried GP in the same practice, there’s been an, it was an interesting experience personally. Um, recognising that partnership is a different relationship and it requires different things of the individuals. So as a salary GP, you’re much less of a threat. And so perhaps the partner is easy, is, you know, finds it easier to engage, easier to accept suggestions and recognises you as an employee to whom they have urm certain defined responsibilities. Um, but as a partner it’s both a more, is intimate the right word? I don’t know that intimate is the right word, but it’s a more entangled relationship and more complex relationship. Um, uh, and therefore it can feel, I think sometimes more threatening, more scary, um, for, for people.

Rachel Morris: (07:13)
Yeah. And I, certainly in the coaching that I’ve done with, um, with managers who’ve actually been promoted and moved, moved up a level. It’s exactly the same. So whereas they’d had a boss that’s been fine with them, whilst they were subordinate, as it were, as soon as they’d been promoted to be over – on the same level as their boss. You’re right, the relationship changes doesn’t it, there’s no longer that sort of hierarchical understanding of, well, if I say something, it’s probably just going to happen. Now it’s, well actually if we’re, if we’re partners then I can’t just tell you what to do. I’ll tell you what’s going to happen. But it sounds like if the senior part is still trying to be a bit hierarchical, and is being hierarchical with the rest of his partners as well.

Jamie Wyllie: (07:50)
Well, I mean it’s interesting isn’t it? Where do you think that comes from? I think, I mean, I, I think what I hear in the story is a sense of, of almost anxiety in the senior partner. I, it’s always difficult in a conversation like this where one’s innate sympathies lie with the person who’s saying, hang on, I’ve made this step and suddenly it’s got difficult and you feel for them. But equally, I have to say in this, in this scenario, I really feel for the senior partner. I, you know, set the practice up 30 years ago, has worked in it consistently has built it and has served patients. And you think about the NHS now and the amount of change that they’re having to, that we’re having to engage with day by day and that the senior partners having to engage with and the anxiety that will be provoking the senior partners. They think about networks and it’s just so complex and different and difficult. Um, I, I feel for the senior partner because they’re struggling and their feeling, they’re feeling anxious, I suspect.

Rachel Morris: (08:49)
Yeah. And I know that when we teach that negotiation on the lead, manage, thrive course, we always talk about trying to drill down to the interests and needs of the other person. And that’s really just by, I guess listening to what to what their fears and worries are. I guess if you’re going to be retiring sooner. A lot of, a lot of older GPs that I speak to say to me, I just don’t want to burn out before I retire. That’s my one goal is just to be able to survive and cope. And it may be that for this chap, he’s just actually on the edge of what he can cope with and the thought that they’ve got to do that for the next three years. Don’t put anything else on me. Don’t put any more change, don’t change the systems that I’ve been working with that I’m just about coping. How could this person find that out from the senior partner? You know, would you recommend asking him outright, or how should, how should they approach it?

Jamie Wyllie: (09:40)
It’s going to depend on the knowledge of the person, isn’t it? But, uh, my, my gut call is that, that, you know, you have that slight moment of, I guess what Sir Alex Ferguson would call squeaky bum time where you just feel those buttocks clench don’t you, as you imagine this new partner just wandering in at coffee time and going, so how are you feeling? Are you stressed? It’s not going to work well, is it?

Rachel Morris: (10:09)
No.

Jamie Wyllie: (10:09)
But it does feel like maybe finding ways into that conversation kind of kind of finding lateral ways in rather than going full on, the full frontal assault probably not way forward.

Rachel Morris: (10:19)
I love, I love these. Um, these metaphors you’re using Jamie. My mind is now full of all sorts of things and full frontal and squeaky bums.

Jamie Wyllie: (10:29)
Yeah. It’s perhaps a slightly unfortunate mixed metaphor.

Rachel Morris: (10:34)
But if you do need to understand where someone’s coming from and it is, it is so important, how, how can you do that without it being really cringy and really obvious?

Speaker 4: (10:46)
So I think this comes from relationship, doesn’t it? The question is, is there a, is there a, the question in my mind is, uh, is there a, a way in which this practice relates to one another? Um, what’s the, um, what my colleague Riaz would call the culture of the practice, um, uh, is this a practice that sits down together that talks about things that has a regular coffee break or is this a practice where you come in, you sit down and you log on, you close the door and then you run out again as fast as you can without talking to anyone so you don’t get involved in any of that stuff. And because frankly, life’s busy enough, I don’t have time for coffee. The coffee break or similar, does it have to be a coffee break? I guess it probably doesn’t. There would be other ways of doing it, but some form of social contact is absolutely vital.

Jamie Wyllie: (11:32)
Um, because, uh, as, as a partnership you’re working in relationship and if the only time that you work on that relationship, um, is when you’re actually trying to do the business together, you’re not so much focused then on the relationship. You’re focused on the business and the outcomes and what your, the decisions you’re taking together. So you never learn who one another are, or how you tick, how to get at this stuff. Um, uh, I mean, I guess my, my gut feeling would be to say maybe try if there isn’t a regular meeting, uh, that’s, that is at least somewhat social, um, that you try to introduce it. And the great thing about medicine is that you can do social over the medicine in the sense that, um, that maybe in a business meeting you’re focusing on decision making and talking about the management and all of that stuff. Whereas it’s much easier somehow when we’re less invested I guess, it’s less threatening to say, oh, I saw this patient and what do you think? And gradually, that gets you into the discussion where you’re able to say what are you doing this weekend? You know, what’s this partner’s family set up? Has kids moved on? What’s going on with them? Is he worried about income? There’s all sorts of stuff that might be going on, but you won’t get at it unless you’ve got a relationship.

Rachel Morris: (12:55)
Yeah. And just makes me think that actually that they’re a partnership, right? So they are going to be other people who’ve been there longer, that probably know him better and maybe they’re the person to really find out what the background worries are. You know, they might have worked together for 20 years. I mean that might be a plus. It might be a minus. Now we had, you know, I heard recently of a practice where there were two partners and they just hated each other and didn’t speak to each other. It’s like crumbs. So you know, if there was some better relationships with some of the other partners or some deep, not better, but deeper relationships and maybe they, they can get on the same branch a little bit easier and really understand what the motivation is. I was just thinking, um, there’s a quite an interesting model by Conan Bradford about how you influence without, without the hierarchy.

Rachel Morris: (13:42)
So I guess in a partner in a partnership it’s supposed to be flat isn’t it? But then there is always someone who’s been there longer and sees himself as the leader perhaps or there might be a managing partner or you know, you might have quite intentionally said, right, you are the leader at the moment. Um, but they talk about to these, these different types of currency. One is about, you know, are you motivated? Is your currency about status, about how you’re seen or is it, you may specify by finance, um, are you motivated by being inspirational or is it by the task getting stuff done or you know, position related would be about sort of recognition and reputation. What, what can this person do to try and work out how the senior partner is motivated?

Jamie Wyllie: (14:26)
I think you’re absolutely right that talking to other partners who’ve worked with them longer is likely to be a good way of doing it. But I think also just noticing, um, this stuff comes out as you make decisions together. Maybe not decisions about, you know, where are we going to have the Christmas party? Um, but the bigger decisions about what are we gonna do about the network, what are we gonna do about staffing levels, those sorts of things. And it’s legitimate in those discussions to, say, okay, I’m getting a sense that, that you and I are thinking differently about this. Can you help me understand what, what is it about the suggestion about bringing onboard another GP, um, that’s, that’s concerning you. What, what am I not seeing? I think it’s legitimate also for this individual to recognise that they are, they’re new partner and so there’s a lot to learn in partnership, isn’t there?

Jamie Wyllie: (15:17)
I think I saw him as a partner for about nine years I think. Um, and I was only scratching the surface by then. Um, and so I think there is something about recognising that it’s legitimate to say, help me understand – what am I not seeing? Are there business decisions that the business influences here? Is it just that it’s the thought of the change and you’re, you’re absolutely sinking and it’s perfectly legitimate to recognise if someone is absolutely sinking and feels as though their nose is only just above the water line. Change such as bringing in doc man or bringing in a new partner. Um, those changes require investment. I haven’t got the capacity for that investment. That change will look very, very daunting.

Rachel Morris: (16:00)
Yeah. And I did, did a podcast recently with Ben Gowland when we talked about how you start to get change in practices where it might be full of people who are resistant. And we talked about how, you know, just starting with one change with one patient for one, on one occasion and then telling the story about how that’s worked and helping the person see, you know, the reason why you need to change all those, all those sorts of things, and the book we were referring to is, I think it’s called Help. Our iceberg is melting. Um, so you know how you actually communicate that change with people. Um, so I think, you know, if anyone’s interested in that, go, go listen to the podcast I did with Ben Gowland cause it’s really interesting what he had to say. This, but this particular partner it was just striking me that you know, he, he’s up to his eyeballs in work, he’s gonna retire soon. He may be struggling to even see what could be done differently. And I guess one, one question I often ask people in coaching is if you could wave a magic wand, what would be happening? And that’s really nice because it sort of removes all the blockers. So maybe they could try and in partnership meeting saying, look, if we could wave a magic wand, what would be happening in this practice? And then get out, some ideas. Well you know, someone else would be looking at the letters for us. We’d have probably a few more GPs and ask, ask him what does he see? If you could wave a magic wand, what could be happening? And if he says, well we’d be doing exactly the same. Say well this is that your magical scenario that you’re working this hard, but that things are exactly the same. And probably, probably it’s not.

Jamie Wyllie: (17:30)
I think in some, I mean I maybe reading my own kind of where I’m at personally, um, I may be reading that into this individual’s world, but um, but I think for some of our older colleagues there’s a, there’s an enormous sense of bereavement. Yeah, it was better and somehow it’s got broken. Um, and that might be articulated as blame of politics or you know, NHS England or all the changes or the fact that there aren’t enough GPs or the fact that the, the, the newer generation of GPs of this or that or that or you know, but actually what sits underneath that is the sense of bereavement. If you gave me a magic wand, I’d go back 20 years because it was better. I had better relationships with my patients, I was better able to care. And I think sometimes being able to say no, but hold on actually there is a, there is another narrative which we would recognise, which is that, you know, and that might be that, well things are different, the population is growing but also we are, we are delivering better care. Outcomes are better than they were 20 years ago and that has complicated our lives. No doubt about it the medicine has gotten more complex and patients have gotten more elderly and complex but actually is, it is better care. Although the relationships with patients are harder and so capturing that sense of well what is it? What’s the heart of it for you? Is it the relationship with patients? That would be legitimate. Or is it that actually you love the fact that 20 years ago you were able to walk into the surgery, feel like you did a good job, walk out and go and have two hours, two hours at home at lunchtime. That also is not, it’s not illegitimate to feel that way, but if you want to get back to that, then you’re going to need to embrace that change of, okay, so someone else is going to need to deal with the paperwork and we’re going to need a practice pharmacist or maybe two or three so that they can deal with a lot of the prescribing queries and we’re going to need to employ a paramedic so that they can help us with visits. And then suddenly once we’ve done that, look, you’ve got your two hour lunch back. Unless that’s not a, I think there’s sometimes this feeling of guilt of we can’t say, oh I, I, I really wish I didn’t have to work so hard. I wish I could get home.

Rachel Morris: (19:43)
Yeah.

Jamie Wyllie: (19:43)
That’s not, that’s not a bad wish.

Rachel Morris: (19:46)
Yeah, I know. Is it, we, yeah. We seem to see it as sort of weak, if we’re not prepared to just put up with the whole er, you know, working 13 hour days and you know, we just just put our heads down and just get on with it. And you know, GPs, I think are incredibly resilient because we’ve, we, we’ve just had to be cause, because there is no one else who’s going to take up the slack. If you don’t deal with that blood result, you know, there’s no one else that’s going to deal with it for you, if you’re it, if you’re on call or whatever. So it’s, you know, we, we’ve, we’ve got that mindset but there comes a point where that mindset then becomes really dangerous to our health, um, and our feelings of happiness and in engagement with work. So I’m just, I’m just interested what you said right at the beginning actually. The only person that we can change is ourselves. Um, no matter how much we try and influence, what other small things do you think this person could do to help this situation?

Jamie Wyllie: (20:43)
I think engaging with, engaging with the partner themselves, engaging with, um, engaging with the other partners and trying to understand that’s what we’ve covered. I think the other thing I would, I would just, this is a harder one, particularly if you’re the junior partner, but for me there’s something here about the definition of partnership. Um, I think many of our colleagues, um, deal with partnership as though it’s as though it’s just uh, it’s just an employment model. Um, or it’s just a contractual model or it’s just uh, it’s a legal arrangement. Um, but I, I think I would probably say that I, I’m, I’m a fan of Peter Block’s definition of partnership. Um, uh, currently reading his book, which is called stewardship choosing service over self-interest. Um, it’s a really interesting read. It will, it will in equal parts, fascinate and infuriate I suspect um, those of us working in service industries, um, but he talks about partnership as having kind of four core definitions, uh, the first of which, and he’s talking, he’s using partnership in a technical sense, not in the sense of a legal partnership, but in the sense of a way of engaging with an organisation.

Rachel Morris: (22:00)
Partnering.

Jamie Wyllie: (22:01)
Absolutely. Seeking to move to a model of partnership as opposed to patriarchy is how he would set it up. Um, and it, you know, you read the book and it’s inspiring. It’s very attractive. But also I have to say, I think that approach to our organisations of, of trying to work in partnership rather than trying to look rather than trying to lean on command and control. Um, I would say I think I, I’ve seen that be far more fruitful. Um, both in terms of the human interactions. It makes places more pleasant places to work, but also more successful, more thriving organisations. But his four definitions of partnership are – start with exchange of purpose, but there has to be a conversation about what the purpose of this organisation is. Um, uh, and we have to talk to one another about why we’re doing what we’re doing.

Jamie Wyllie: (22:52)
Um, uh, so there’s, uh, there’s something in this scenario that we’ve set up, um, of that, the partnership, having that conversation with one another. What is the, uh, what is the exchange of purpose? Where, where did they have that conversation? How do they broker between one another? Um, what they really think they’re doing, why they’re doing what they’re doing. Um, so something about exchanging purpose. Um, so yeah, for what it’s worth, his other definitions are, uh, the right to say no. It doesn’t mean that you always get your way, but it means that you never lose your voice. You always have a right to disagree. Um, joint accountability. There is nobody else to blame other than the partners. Um, uh, and the requirement that brings them for absolute honesty and that honesty is a key part of partnership. And I think that’s, those are really helpful concepts for people engaging in or thinking about engaging partnership to recognise that something like that has to be the foundation of a partnership relationship.

Rachel Morris: (23:49)
Wow. I love those. Exchange of purpose. The right to say no. Joint accountability, and absolute honesty.

Jamie Wyllie: (23:55)
Yeah. Yeah, and that’s Peter Block’s not me. Just credit where it’s due. So yeah. But I really liked that as a, as a definition of kind of the core, but the beating heart of partnership.

Rachel Morris: (24:06)
Yeah. So it’s really interesting having sort of worked with various partnerships and things. I think a lot of them, have the right to say no. Um, and a lot of them, well they just have joint accountability because they are liable but I don’t think they’ve done the exchange of purpose or the absolute honesty. And what they do is they then just use the right say no all the time instead of the honesty. It’s just like, nope, vito that, vito that. Cause I can’t really be honest about the fact that I don’t want to try this new scheme cause I’m too knackered to be able to even think about doing something differently. So I’m just going to say no.

Jamie Wyllie: (24:43)
And I think Block would call that abdication. Um, and what he says is that one of his, one of the quotes of his that I really love is that abdication for an individual and he uses the word manager, but I think I would be more comfortable using the word leader in a, in a partnership context, uh, or perhaps even partner. Um, but advocation for individual partners, the first step, uh, to supporting anarchy is a governance strategy.

Rachel Morris: (25:06)
Gosh.

Jamie Wyllie: (25:07)
If you, if all you ever do is say no and you’re withdrawing and kind of stepping back, really what you’re doing is saying that there is no, there is no governance strategy. There’s no, there’s no way of brokering and making decisions.

Rachel Morris: (25:21)
Yeah.

Jamie Wyllie: (25:21)
But I think I probably want to drill into that sense of wealth. They have joint accountability because they are partners and I think that is, I don’t think that’s the heart of what Block’s saying. I think the heart of what he’s saying is that it’s owning that joint accountability and recognising that there is no one else to blame. There’s nowhere else to go. Everything that happens in the organisation is actually something that I will own. Um, now that’s not about feeling massively overburdened because what he would say is if you feel massively overburdened by that, what’s probably going on is you’re still operating inside a model of patriarchy that you believe you own all the people and therefore they are your responsibility. If they were all in partnership with you, then they are all jointly accountable and suddenly it becomes a much more comfortable place. But that sense of owning that the way people talk to one another, the way business gets done, uh, the way care gets arranged, the way the receptionists talk to the patients. Actually all of that is a reflection of, of me and I own that. That both brings enormous responsibility, but it also gives us enormous agency that actually we can change it. And there’s a whole other conversation in there, isn’t there about how, you know, culture and culture change and how one engages with that and how one does that. Um, uh, and yeah, maybe that’s one for another podcast.

Rachel Morris: (26:47)
And just strikes me as well. Some of the practices I’ve seen, they have abdicated their accountability and made the practice manager accountable and then the partners won’t make any decisions. And the, and the poor old practice manager is trying to run the practice seems to be accountable for everything. But all the partners are saying is no, or not even saying no, they’re just not even making any decisions. So the practice managers are tearing their hair out going, well, I’ve asked them about this, I’ve asked them about this. I’ve told them that we really need to do this with the nurses, otherwise they’re going to leave, but they just won’t make a decision. And that, I guess not making decisions is a passive aggressive way of just saying no to stuff.

Jamie Wyllie: (27:26)
Yeah.

Rachel Morris: (27:26)
In a way.

Jamie Wyllie: (27:27)
Or perhaps is a reflection of the profound anxiety that leading organisations causes, particularly in times of great change when it was already clear that your job as a partner was basically to come to work to see the patients and you know, and, and that was it. Um, it was easier and now you gotta make all these decisions and it’s difficult, and the recruitment environment sucks and you got PCN ballooning next door and you’re a bit suspicious of practice. That’s the lead practice for the PCN and just the whole thing provokes enormous anxiety. And I think for some people what that leads to is a kind of paralysis of decision making. But the anxiety is what prevents us. I don’t know that I have an easy answer for that one though. Right. Any thoughts?

Rachel Morris: (28:19)
Well, I was just thinking you could probably start by writing. If you’re in a partnership like this, just writing down what you reckon your job description is as a partner. You know, what, what am I, what are we all here for? Maybe you could do that as a team exercise. What is our, if we were to, if we were to pay hundreds of thousand pounds to external consultants to come and look at us and tell us what our job descriptions were, what would they say they are actually looking at us. What would they say they were looking at us and what, what would they say that they were, if we actually properly thought about it. And that would be quite interesting then to look at the difference between what partners are actually doing and what they should be doing as partners.

Jamie Wyllie: (28:57)
But I think there’s also, there’s something about, you know, that sense of writing your own job description, um, of saying, well, if I was going to apply for a job, what would I want it to be like? What do I actually want? What are the bits that I have to carry that I really don’t want to carry. And maybe you know, maybe if you asked this senior partner to write his perfect job description, what you might find is that the perfect job description that he writes is essentially a salaried GP.

Rachel Morris: (29:24)
Yeah, yeah.

Jamie Wyllie: (29:24)
And that perhaps the, some finding some way of, of helping him to recognise that maybe actually he’s, he’s at the point where he doesn’t, he doesn’t really want to be engaged in all of this stuff. And that just coming in and seeing the patients and going home again is, is enough that three years to retirement, that’s what works for him and maybe that could work for the practice. If you offered him the opportunity to write that job description. Who knows? That’s a really powerful suggestion Rachel. It’s really interesting.

Rachel Morris: (29:55)
Thank you.

Jamie Wyllie: (29:55)
Not something I’ve ever done.

Rachel Morris: (29:58)
No, I just, it yeah, cause it just strikes me as that, you know, when we go back to how this chap is reacting in the meetings, um, you know, I talk a lot about our amygdalas being activated and us going into our fight, flight or freeze zones. It sounds to me like when the other partners are suggesting stuff, his amygdala is activated, he’s not, you know, a rational person would think actually yes it’s going to be good for the practice, it’s going to reduce my work, let’s go with it. But you know, one of the threats that we feel as human beings, it’s completely unconscious, it’s our inner Chimp coming out. It’s a hierarchical threat. So if he feels there’s any sort of hierarchical threat or a threat to his work or something, he suddenly starts thinking in his amygdala fight, flight or freeze zone. And he’s not thinking straight anyway. So it’s thinking of ways in which they could raise this stuff that’s not going to trigger him, that’s not gonna make him feel threatened immediately. So sort of saying, look, we don’t want to provide any more work for you. You know, maybe one of us can go and investigate some stuff and absolutely we will bring it to the partnership and nothing is going to be forced on you that you don’t want to do. So it’ll give them a getting out clause, although, I guess you have to be careful with that because if the rest of the partnership thinks everyone should do it then maybe, but you know, just reassure him that you’re not threatening his status as senior partner. You’re actually, um, trying to make things better. So just avoiding that, that triggering response, which is using empathy, which is listening, which is being careful of the language that you’re using. Um, um, and being, I guess this is where you probably want to be very collaborative in your language as opposed to very autocratic, you know, cause you don’t want to go sort of Chimp to Chimp as it were.

Jamie Wyllie: (31:38)
Yes.

Rachel Morris: (31:41)
Um. Yeah. So I think, you know, it’s again, communication skills and, and, and actually asking, asking questions as a way of inquiring rather than saying, I think we should do this, what do you think? Say to the senior partner I’ve been really thinking about how we can improve our, our, our work late. Do you have any suggestions? Have you considered anything? I’ve got a few that I’d love to share, but you know, what’s your gut feeling about this? So they get a chance to share. So then you’re sort of co-creating this as well.

Jamie Wyllie: (32:07)
Yes. Yeah. I think that’s, that’s really, that’s really positive isn’t it? And I think, I guess the one other thing I’d say is that it’s worth thinking about practice away days, um, or doing it, you know, if it’s not in an way day, then doing it over a weekend or something like that, but so you’re out of the run and you’re not in the context of the day to day stress. So that all of those, you know, all of that good stuff, um, is easier to do. Whereas when we come to these conversations played out, having had a stressful, challenging morning surgery and with three visits sitting on our, on our shoulder that we know we’ve got to get to, but unfortunately we know we’ve got the meeting. Um, it’s very hard then to listen well, to practice empathy, to watch the other person’s body language, to be careful about our own use of language, to manage our own internal environment such that we don’t then end up lighting up as people say stuff. It’s just easier to do it when you’re your best version of yourself, which for me is not at 1:00 PM on a Monday.

Rachel Morris: (33:09)
Yeah, we do try and get everything done, don’t we within practice. And I think, you know, a lot of people want to keep working work. So the idea of having practice meetings outside of office hours as it were is sort of fairly intolerable. But, but if, if, if you genuinely can’t find some good time or you can’t take some time off within your hours to get away, and do an away day then doing it at the weekend or the evening is probably really, really important. I mean, I, my, my feeling is, and I probably would say this is as a team coach and somebody who does facilitate away days, is that you need to be making time for this within your working hours. Um, to actually get away and to do this practice development work cause it’s so important. Most practices spend a lot of time, you know, like you said in business meetings, but absolutely no time working on the team. How are we working? How are we interacting together? Do we need to shift shifts and shuffle around some responsibilities to make us work better. Cause absolutely. Why should one person carry the can for being senior partner? I’m thinking this senior partner probably feels this massive weight of responsibility that it’s up to them to sort the practice out.

Jamie Wyllie: (34:17)
Yeah.

Rachel Morris: (34:17)
And probably if they realised that the others really want to help and really want to take on some of that burden, probably be, feel a massive weight off their mind.

Jamie Wyllie: (34:26)
Yeah, I think that’s, that’s very likely to be the case. I mean there’s a quote from um, Earl Shorris, which, um, Peter Block uses in which he says in business, people do not arrive at totalitarian methods because they’re evil, but because they wish to do the good in what seems to them the most efficient way or because they wish merely to survive or with no more evil intents than to prosper. And it’s that sense of how in this, in this context, what’s very easy is to start to build a picture of the senior partner as being the problem.

Rachel Morris: (35:01)
Um –

Jamie Wyllie: (35:01)
And just stepping back and recognising that this is another human being who’s just coming, who’s just trying to survive, um, or who’s trying to get stuff done in the most efficient way. Uh, this is the way that they’ve fallen into, um, it’s worked for them over time. Um, yeah, I think. But that whole thing of just recognising the other as a, as a human. Mm. And if you don’t spend time together, it’s really hard to do that.

Rachel Morris: (35:26)
Yeah. A hundred percent. And it’s you know, it’s another whole topic. Trust building, building trust within teams. And for that, you know, a very quick resource that you could look at is Patrick Lencioni, the five dysfunctions of a team, which we talk a lot about on the lead, manage, thrive course. And it’s been really, really helpful to me.

Jamie Wyllie: (35:43)
We love it. Absolutely.

Rachel Morris: (35:44)
Not going to go into it now because we’re out of time. We’ll do another one on, on the five dysfunctions of a team actually, I think, and I just think that quote you read, wow, that is really, really powerful. Um, I think if we just remember that, that that’s just sort of changed my whole perspective actually when I’m thinking about when I’m thinking about this. So thank you. Really good.

Jamie Wyllie: (36:06)
Cool.

Rachel Morris: (36:07)
So, um, let’s wrap it up there Jamie. Thank you so much for coming on. Definitely.

Jamie Wyllie: (36:13)
Always a joy.

Rachel Morris: (36:13)
Definitely getting you back. I think a regular agony, uncle slot. Do you want to be called an agony uncle?

Jamie Wyllie: (36:17)
Perhaps more agony that uncle. But…

Rachel Morris: (36:25)
So if anyone would like to submit a question, could be about anything, we’ll, we’ll, we’ll pull out your best ones. Uh, Jamie and I will do another, another slot on, I think we call it ask the frog. How’s that?

Jamie Wyllie: (36:35)
Ribbit ribbit.

Rachel Morris: (36:37)
Ribbit ribbit brilliant. All right Jamie, have a good rest of the day and thanks for being on and we’ll speak to you soon.

Jamie Wyllie: (36:43)
Thank you very much Rachel, always pleasure and speak again soon.

Rachel Morris: (36:47)
Bye.

Rachel Morris: (36:47)
I hope you enjoyed listening to that episode and I thought it might be useful to give you a list of my top suggestions for cringe free team development activities, which you can use for away days or practice meetings. So if you want to get this fully downloadable list of suggestions for activities, then do click on the link in the show notes, sign up and we will send you the link to it. I hope it helps.

Rachel Morris: (37:13)
Thanks for listening. If you’ve enjoyed this episode then please do subscribe to the podcast and also please rate it on iTunes so that other people can find it too. Do follow me on Twitter at Dr. Rachel Morris, and you can find out more about the face to face and online courses which I run on the youarenotafrog.co.uk website. Bye for now.

Podcast links

Podcast links

Please click here for a free download of cringe-free activities to develop your team – for use in partnership meetings and away days.

The Five Dysfunctions of a Team, Patrick Lencioni

Stewardship: Choosing Service Over Self-Interest, Peter Block

Sign up for downloadable CPD reflection forms plus more tools and resources

For more episodes of You are not a frog, check out our website www.youarenotafrog.co.uk and sign up to our mailing list here for loads of useful resources about thriving at work.

Follow Rachel on twitter @DrRachelMorris or LinkedIn and find out more about her online and face to face courses for doctors on surviving and thriving at work at www.shapesfordoctors.com or for other organisations at www.wildmonday.co.uk

Episode 20 – A creative solution to stress with Ruth Cocksedge

In this episode, Rachel is joined by Ruth Cocksedge a Practitioner Psychologist who started her career as a mental health nurse. She practices in Cambridge and has a particular interest in EMDR for PTSD and creative writing as a way to improve mental health and wellbeing.

Episode 11 – The magical art of reading sweary books

In this episode, Rachel is joined once again by Dr Liz O’Riordan, the ‘Breast Surgeon with Breast Cancer’, TEDx speaker, author, blogger, triathlete and all round superstar who has been nominated for ‘Woman of the Year’.

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2019-12-10T16:05:57+00:00