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My Journey to Power

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Yeah, there are risks with the feedback of superiors, especially when negative.

But still, it's a fantastic opportunity and a great tool to spot potential bad apples that may have instead gone a whole career unnoticed.

From your point of view, John, I'd make sure that you frame the initiative as an initiative to add value, and not as a "assessment from the bottom up".
People who reach a position of power don't want to lose that power to those below them, especially not when they didn't have that power and opportunity going up -they feel it's now their turn to absolute power, and cheated if that's not the case-.

So albeit there is a lot of power in being the guy who checks and reports on internal governance, it can be a dark power that makes people fear you, but not like you -and you're generally better off with both, of course-.

Personally, I'd make sure to be extra friendly, frame it as "the new head is interested in this project" (rather than you necessarily pushing it), and frame it as an opportunity for the hospital, the patients, and opportunity for them to get good feedback, more residents in the future, and do good work.

So this one:

Quote from John Freeman on October 7, 2022, 9:44 pm

I'll also inform the units' leaders that now they're going to be evaluated by residents. I will validate the email with him before sending it first.

Would become something like:

The residents will have an opportunity to share about their good experience in the units.

The power move is all there anyway, but less dark power, and more high-power, high-warmth :).

John Freeman and Bel have reacted to this post.
John FreemanBel
Have you read the forum guidelines for effective communication already?

Thank you very much Lucio and Bel!

this is very useful for us. I want to stress that when you guys answer on this topic you're not only helping me but the future 84 others Swiss paediatricians. This is NOT an incentive to answer to eventual future questions about this topic. This also not a covert power move (I'm more than 1). This is a feed-back on the impact you guys are having. It's a fact. There is a multiplying effect of everything you guys are helping me with on this topic. I wanted you to know the importance YOU have on this matter.

But still, it's a fantastic opportunity and a great tool to spot potential bad apples that may have instead gone a whole career unnoticed.

Yes.

From your point of view, John, I'd make sure that you frame the initiative as an initiative to add value, and not as a "assessment from the bottom up".

Key.

People who reach a position of power don't want to lose that power to those below them, especially not when they didn't have that power and opportunity going up -they feel it's now their turn to absolute power, and cheated if that's not the case-.

True, I was not aware of this.

So albeit there is a lot of power in being the guy who checks and reports on internal governance, it can be a dark power that makes people fear you, but not like you -and you're generally better off with both, of course-.

Same as above. My intention is neither to be punitive nor out of revenge (even if there was some feelings of anger like this in me before). This is helping me in putting my mind in the right direction in the "feed-back from bottom" vs "general improvement of the service's inner workings" matter.

Personally, I'd make sure to be extra friendly, frame it as "the new head is interested in this project" (rather than you necessarily pushing it), and frame it as an opportunity for the hospital, the patients, and opportunity for themto get good feedback, more residents in the future, and do good work.

In bold: key, thanks. Right, I will do this.

So this one:

Quote from John Freeman on October 7, 2022, 9:44 pm

I'll also inform the units' leaders that now they're going to be evaluated by residents. I will validate the email with him before sending it first.

Would become something like:

The residents will have an opportunity to share about their good experience in the units.

The power move is all there anyway, but less dark power, and more high-power, high-warmth :).

Gold nugget, thanks a lot!

Previous experience

I studied at an international engineering school where we were asked to evaluate professors anonymously. It was between 65 and 200 people, depending on the year: 200 in first year, 65 in last year. So it was 100% sure that no one could be identified due to the process (anonymous online survey) and the sheer number of people.

Then, the results would be processed and summarised by the responsible unit. The results were then transmitted to the professor. Then, the results were presented by the professor to the students. He would be self-critical and address what would be changed and what would not be and for what reasons.

Current vision

Thanks to your feed-back and my previous experience, I think that in addition to the mindset, the process of collecting and presenting the results matter a lot. Here is the process.

Fabrication: making the survey according to criteria is not a big deal. We have templates, ideas, etc. That's not a major issue and can be improved with time based on feed-backs from residents and units' leaders.

Distribution: not a major deal, using online methods outside of email can solve this (Monkey Survey).

Collection: has to be done anonymously, here the challenge is that sometimes there is only 1 resident in the unit. So anonymity cannot be guaranteed in this case. I think there is a way of mitigating this. In the beginning, we could collect anonymously all the surveys without asking to specify what unit they are in. This would give an overall view of the service. Advantage: anonymity issue solved, the big boss can still have some gross data to drive the service. Challenges: the good units and the bad ones could not be identified and separated, and therefore specific problems could not be identified.

Processing: nothing really major here. It's about summarising the results.

Presentation: I think it's important to present the results to the units' leaders AND the residents.

a) We could use the process from my previous school. The problem is that the leader would face the one resident in his unit so it would fuck up the anonymity. It could be presented in a big assembly of residents. Units' leaders would have their face saved as they would not be present. However, I'm wondering if this is optimal.

b) If we present publicly the results of all units to other unit's leaders, then it's an issue because some would lose face and it would only exacerbate internal tensions and competition.

c) There's an idea: the results could be presented in powerpoint only (no written results sent, no picture allowed) in different formats once per year:

i) First, to the big boss of ALL units. Out of respect for hierarchy and so he can have an overview of the situation. He could not share the written results with unit's leaders.

ii) Individually to units' leaders. This could only be done after there are at least 2 residents who went through the unit. That means: 6 months, 1 resident, no feed-back, after 1 year 2 residents: return to the unit's leaders. Statistically, the minimum is 3, so that is an option as well. For units with more staff (8 residents or so), feed-back could be given after 1 rotation only.

iii) Collectively to the residents: so they can compare the units and also realise that the issues that they encounter are common to other residents. This would alleviate the feeling of shame and isolation, leading to self-censorship. This would also foster a feeling of togetherness, that would lower the feeling of dog-eat-dog that can sometimes arise in the "career competition".

What do you guys think of this?

Of course, we're going to discuss it in our next meeting with the committee. What you guys told me already helped tons. See, I could come up with the plan above.

Other issue

The big boss also told me that there are issues regarding the evaluations from the unit's leaders. They do great evaluations on paper and then say privately between them: "Yeah no, this guy is shit, he's never going to make it". So there is a discrepancy here that he want (so do we) solve.

Basically, now we finally go towards excellence (continuous improvement and learning). Before, mediocrity was king. We were stuck. As a friend told me: "our hospital is a mental prison", that is also my opinion. People were discouraged to think critically and voice their opinions. Without critical thinking and the possibility to voice opinions, no improvement is possible I think.

Thank you very much again. I think this situation is actually a good case study as what social skills and power awareness can do for someone (me in this case of course) and how it extends to a large group through leadership (no status inflating, fact).

Bel has reacted to this post.
Bel

Interesting development regarding the comittee. So we have now our generic email, so we all see the messages.

Chief of paediatric infectiology

The chief of the paediatric infectiology unit contacted us to send a reminder to the residents regarding a job offer where he only got 1 answer. I write an email to sale this job offer to the residents and sent it to all. I did it in the 2 hours he wrote the email. He was thankful. One more favour, more power for us.

Chief of paediatric surgery

The chief of paediatric surgery contacted us to know if the residents included are only residents in paediatrics or also residents in paediatric surgery and those in child psychology. My plan was to include the residents in pediatrics surgery later in the process (6 months to a year from now). So I answered him only the residents in pediatrics. That this was the topic of our next encounter (a true lie: by writing this email it pushed it higher on our agenda, so he set this in motion). It's going to be the topic of our next encounter NOW that you sent me this email.

So it seems he wants to make sure his residents in surgery are not included. I think he feels the wind is changing. I told him we could meet after our encounter. He said: "we'll see depending on your decisions", which sounds like a threat. So now he's actually helping me. I'm going to meet the resident physicians in paediatric surgery and ask them what they think

Chief of Human Resources

She tried to call me twice (really eager to talk to me). We never hear anything from them so I thought it was bad news regarding my job. I never get a call from Human Resources. Guess what she was interested in? Talking to the committee of course. "So we can get to know each other" and that now they're trying to have "More visibility". So this seems to me politicking at it's finest. There's no project, no reason other than "getting to know each other". Also she wants to know what projects we're working on. So she wants 1. info. 2. allies. She tried to call me twice and then sent a long email. She seems quite desperate.

The new chief arrived and the slackers smell it's not good for them. I now know from a colleague that Human Resources met every residents from intensive care in the past 2 weeks. They never did that before. I also know from the administrative assistante (right arm of the new boss) that 2 of them came to a meeting last months where they never went before.

So I think HR are in an "operation seduction" due to the coming of the new chief. She admitted they want more "visibility". They work in another building which is quite luxurious. They end their job at 5pm or 4pm on Fridays (I was there, empty building). They never get in contact with patients, don't understand our jobs. So basically they are living in their own bubble making absurd decisions (I know I heard them from my new connections) and now they want a part of the pie of our committee. They think we are naive and so they can take from us.

Seeing her game, I went all in, playing the naive giver. I said: "If you want I could make the same presentation I did to the head of the service and the head of the department (juicy high level info!!!! -> bait)." Her: "Yeaah, sure" (enthusiastic, hooked). Of course, I'm not going to do the same presentation. I'm going to do a watered-down presentation. I'm going to present the committee and talk about a little project or two, not the main juicy ones. Just to make us look serious and at the same time amateur and small time politicians. Just so she does not suspect we're powerful (which we are now, see who's writing to us). In my 4 years in this institution, I interacted with HR only when I arrived. So they do "zit" for us as residents.

So as you guys see, this new committee and the announcement got us some big fishes in the net. I love this game of politics!

This is only the beginning. 🙂

As always, happy to hear any thoughts/comments.

Cheers!

Lucio Buffalmano has reacted to this post.
Lucio Buffalmano

Ahahah look at the politicking bitches now making moves :D.

I'd personally want to make friends with HR, they may have good connections in the field and they're always best on your side.

Your proposal to give them the same presentation is great because you may be able to meet a whole bunch fo them, including the higher-ups -instead of only one single person they send to gather the info, which may not the be real mover and shaker-.

Generally speaking, for meeting 1:1 I'd generally propose "lunch together", just to show that you're busy and take your working time seriously and aren't going to sit for coffees.

John Freeman and Bel have reacted to this post.
John FreemanBel
Have you read the forum guidelines for effective communication already?

Thank you for your answer, Lucio!

If you think HR can be valuable allies, I’m going to give them the same presentation with the juicy information. Not watered down.

Yes I’m meeting her after work.

Since my last post I enquired towards a pediatric resident friend of mine. He told me that the chief of pediatric surgery actually want things to move forward. So he probably wants to do the same thing in their department. I was too suspicious. My current plan after having talked with my colleagues is to do exactly that. 1. Meet with him to tell him we support the same initiative in pediatric surgery. 2. Meet the 2 residents who actually want to do pediatric surgery (others want to do other surgical specialties) and tell them how we did it so they can do the same.

Then we’ll do the same for child psychiatry.

Lucio Buffalmano has reacted to this post.
Lucio Buffalmano

Correction: I enquired to a pediatric surgery resident friend of mine.

Hello guys,

I'm almost done with my deadlines. In the mean time:

Social credit reversal with my sister

It's an example of social scalping. It has already been named here as a way to make it look as it's the other one giving whereas they are taking.

Context

This is all happening on WhatsApp.

My sister asked me to keep the children while they are finishing to pack the boxes since they're moving out. I was supposed to help them on Sunday and I got sick on Tuesday from a little patient (sore throat, fever, muscle pain, chills, tired). I still went to work on Tuesday as in my line of work you're supposed to come to work unless you are completely incapacitated (which I half was). Ended up dead tired.

Wednesday I had a training for a certificate for my job. Was completely dead, but I still passed with high colours.

Today I was still feeling quite sick so I let her know so she could find a solution instead of me cancelling last minute.

The social exchange

I propose her to let her know on Saturday evening how am I feeling

She proposes me to ask the grand parents and cancel as telling someone last minute the change of plan is not nice, is it? (her question: light guilt tripping, it's actually her best interest to have someone sure).

I agree with cancelling as it is more simple (reframing it as simpler rather than more ethical, cancels the light guilt tripping).

I propose another date (the 4th). She's not available.

She proposes another date (the 11th), I'm available and confirm.

She tells me that it's too close to the housewarming (the 17th) and now it's worth analysing the text:

Her: Listen, I don't know if that is really useful. The eleventh will be 4 days before moving out and we will really need the full day without children to advance. We will rather ask the grand parents I think, to make sure we make it. It's not personal at all, John. I hope you don't take it the wrong way. I just think that half a day will not be enough and we are already swamped with work.

Me: Your answer comes at the right time. I found what I have and I'm taking antibiotics, so it's going to work for me 🙂 So let's keep the initial plan. BTW, I also thought the eleventh was a little bit short. I was a bit surprised that you propose this date. But it's all good, it's settled.

Her: But are you sure? Will you be well enough? I don't want to pressure you...

Me: Don't worry, it's my decision 🙂 Antibiotics are spectacular, I was not expecting it.

Analysis

Ground: I'm rendering a service and she's turning it around. She already did it in the past: "you get to see the kids" whereas I was giving them free time: fair exchange but she was framing it this way.

Her: Listen, I don't know if that is really useful. (minimize the value offering but SHE proposed the date as the 11th). The 11th will be 4 days before moving out and we will really need the full day without children to advance. We will rather ask the grand parents I think, to make sure we make it. It's not personal at all, John. (she frames it as she rejects my offer whereas it was actually her asking me for help). I hope you don't take it the wrong way (frames me as thin skinned and also prevents any defence from me, if I defend I prove I'm thin skinned. I would not have defended anyway as they are the ones needing help. I'm happy to have my free time. She knows that I'm a "a promise is a promise "kind of guy so she takes advantage of my desire/need to honour my promise.They commonly minimize all I do for them or the children (I bring back gifts every time I travel, etc. and the other uncle does none of that, for instance right now my fridge is full of gifts for the family: 4 boxes of chocolates, waffles, cheese, etc.). I just think that half a day will not be enough and we are already swamped with work.

Me: Your answer comes at the right time (Reframe as: no big deal, a change has happened, actually true). I found what I have and I'm taking antibiotics (true and I actually found this out in between us trying to change dates which was better for me and for her as she said so we can have dinner together, but it seems she's more interested in me keeping the children than having dinner with me), so it's going to work for me 🙂 So let's keep the initial plan. BTW, I also thought the eleventh was a little bit short. I was a bit surprised that you propose this date (takes away her frame of her proposing me but then taking back the offer and making it look as if I'm the one not available) But it's all good, it's settled (build back rapport, take the lead).

Her: But are you sure? Will you be well enough? I don't want to pressure you... (this one is difficult to analyse, but it felt a bit manipulative or that she wants to make sure that her plan will work. It does not seem that she cares about my health but more about her moving out, by asking me if I'm sure, she takes more power as it makes it look as I need it more than her).

Me: Don't worry, it's my decision 🙂 (takes back some power: I choose) Antibiotics are spectacular, I was not expecting it (true).

Conclusion

So I still think that my sister has definitely a manipulative and selfish side. Is she a narcissist? I don't know for sure. But she showed in several previous interactions with me that she knows about social credit and how to manipulate it.

I'm looking forward to exchange more with you, one last deadline!

Kavalier has reacted to this post.
Kavalier

Hi John,

These are my impressions

I agree with cancelling as it is more simple (reframing it as simpler rather than more ethical, cancels the light guilt tripping).

I felt here  you needn't have agreed, as it was not your fault, you probably could have said, "it's not about cancelling at all, it's about being concerned, I don't want to pass on the the fever to the kids when they visit,  and I can't take them in hope you understand. "

Quote from John Freeman on November 17, 2022, 8:13 pm

Her: Listen, I don't know if that is really useful. The eleventh will be 4 days before moving out and we will really need the full day without children to

Perhaps you could have reminded her that, it was she who proposed the date like "if it's not useful, why did you propose the 11th? "

I hope you don't take it the wrong way

That puts you in a double bind,  you could have surfaced it asking " what's that supposed to mean?"

Me: Your answer comes at the right time (Reframe as: no big deal, a change has happened, actually true). I found what I have and I'm taking antibiotics (true and I actually found this out in between us trying to change dates which was better for me and for her as she said so we can have dinner together, but it seems she's more interested in me keeping the children than having dinner with me), so it's going to work for me 🙂 So let's keep the initial plan. BTW, I also thought the eleventh was a little bit short. I was a bit surprised that you propose this date (takes away her frame of her proposing me but then taking back the offer and making it look as if I'm the one not available) But it's all good, it's settled (build back rapport, take the lead)

I felt this was a solid answer, which allowed you to maintain rapport.

But are you sure? Will you be well enough? I don't want to pressure you

She might have been concerned about what to do in case the plan doesn't go accordingly and wanted a confirmation to put her mind at ease, but the way it was said seemed like a babying sort of power move to me,  you could have told  her that " you were sure,  and asked if  she has any concerns about the whole thing?"

I haven't read the earlier interaction you two had, but my take on it is, she was concerned about the whole moving in situation, and she was upset when you fell sick, coz it upset her plans. I don't think it shows her being narcissistic or selfish, I could be wrong too.

Thank you

Wou

Lucio Buffalmano, John Freeman and Kavalier have reacted to this post.
Lucio BuffalmanoJohn FreemanKavalier

Yeah, I wouldn't have particularly enjoyed receiving those messages as there are several (covert) power moves.

Also the "nothing personal", reminiscent of the Godfather's famous line -that's not what you usually say to family you care about-.

However, I personally would have probably chosen not to expand any effort in parrying them and just instead kept my replies brief.

John Freeman and Kavalier have reacted to this post.
John FreemanKavalier
Have you read the forum guidelines for effective communication already?

Hello guys,

thank you very much for your answers! These are useful for me.

Next time, I will go the lowest effort route. I did not have this in my arsenal yet.

Cheers!

Lucio Buffalmano has reacted to this post.
Lucio Buffalmano
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