Stop Meeting Madness!!! Meeting Ground Rules

Now that we have looked at a few important organizational dynamics that hinder effective governance in medical groups (lack of adherence to group decisions, conflict avoidance, and getting stuck in the Storming stage of group development), let’s start looking at solutions.

Why Discuss Group Meetings?

We begin with group meetings.  Why group meetings?

1. No matter your group’s size or specialty, meetings are a tool that all groups use in their governance processes.
2. Much of the work of governance is done in group meetings. Yes, there is often a lot of background work done outside of meetings, but the real discussions, debate and decision-making is typically done at group meetings.
3. We have observed that many medical group meetings are chaotic and unproductive.  As we discussed in preceding post about the four stages of group development, many physicians do not understand or appreciate the importance of effective meeting management. If meetings don’t work well, practice governance doesn’t work well.  The wrong issues are discussed, reasonable conclusions are not reached, decisions are not made.

Now some of you won’t pay attention to these ideas because either “we don’t need to do that” or “we don’t want to do that.” However, keep in mind that “Insanity is doing the same thing and expecting a different result.”  The bottom line is that successful governance requires successful meeting processes.

Luckily there are a number of steps that you can take to dramatically improve the effectiveness of your group meetings.  Over the next few posts we will address those steps, but we begin with the need to create and use Ground Rules.

(Note that these ideas will help improve all meetings.  We will discuss the different challenges and solutions related to Board and Shareholder meetings in future posts).

Why Are Ground Rules Needed?

Think about your most recent group meeting.  Did the attendees exhibit any of the following behaviors:

• Multiple people talking at the same time.
• The conversation drifts way off topic.
• Interrupting telephone calls are taken in the meeting room.
• Participants arrive late.
• Low physician attendance.
• Some participate in the discussions, while others don’t (until the “after the meeting meeting”).
• Individuals raise many problems but do not pose solutions.
• There are many sidebar discussions – either by talking to the person seated next to them, or through texting.

Establishing Ground Rules

“Ground Rules” are the observable behaviors that the group members agree are expected from every attendee.  The focus is on observable behaviors.

Let me provide an example of an unobservable behavior.  A Ground Rule that states that everyone is expected to “be open-minded” is subject to dispute, depending on an individual’s viewpoint.  Why? Because being “open-minded” is not a undisputable observable behavior.

It’s best to set Ground Rules as a group process. In other words, you should have the attendees develop the Ground Rules together rather than copy the list below and say “here are our new ground rules.”  Individuals are more likely to adhere to the Ground Rules if they have a hand in developing them.

Identifying Observable Behaviors Is Critical

You should ask the attendees “what observable behaviors should be expected of each attendee?” Their responses should cover the following key Ground Rules:

1. One person speaks at a time and everyone else listens.
2. Arrive on time.
3. Stay on topic.
4. All are expected to participate in the discussion.
5. No sidebar discussions – oral or texting.
6. If you have to take a telephone call, leave the room so work can continue.
7. Everything we discuss is confidential unless we specifically agree otherwise.

During this discussion you might have someone suggest an unobservable behavior such as “we should all focus on what’s best for the group” (something that is not truly observable because it is happening inside an individual’s brain, and each individual can claim to be acting in the best interests of the group). Thank them for their contribution (and maybe even write it down) but keep coming back to observable behaviors like the ones noted above.

Once created, each attendee should be asked if they will abide by the proposed Ground Rules.

Using Ground Rules

Once established, the best performing groups quickly review the Ground Rules at the beginning of every meeting. This doesn’t take long and the pay-off is huge.  Some groups type the Ground Rules at the top of their agenda, while others post the Ground Rules on a cardboard sign that they  bring to each meeting.

Most groups find that group meeting performance will improve simply by verbalizing the Ground Rules. You will likely also find increased meeting attendance as individuals begin to expect more organized and effective meetings.

But the Ground Rules will take on even more importance when they are utilized by the group’s Meeting Manager as we will discuss in a future post.