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Negotiating for Success: Preparing for Successful Negotiation Case Discussion

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Negotiating to Expand the Women’s Health Care Education Program

Dr. Jacobs directs an elective residency rotation in Women’s Health for the Department of Internal Medicine. Over the past three years, she expanded the program from a set of lectures for residents in the department to a six-week clinical rotation with case discussions in sex and gender differences in a variety of topics, including psychiatry, medical complications of obstetrics, disabled women, and health care systems. The six weeks includes experience in gynecology, the surgical breast clinic and her outpatient office.

Her division director had been very supportive of the program but recently suggested that she might need to increase her efforts in activities that provided better funding for her time. Roberta knew exactly what that meant: the time had come to seek independent support for the Women’s Health Program. She needed to procure either grant support or contributions from the departments whose residents rotated through the program. She began by discussing the challenge with the other members of the Women’s Health rotation teaching team.

Dr. Elton, the residency program director for Obstetrics and Gynecology, identified a small departmental grant that would support 10% of her time for one year if they could design a good educational research project. The liaison consultant in Psychiatry, Dr. Stevens, pledged to continue volunteering his time for now but had no funds to contribute. The nurse-educator, hospital nutritionist, and pharmacy educator also voiced interest, but each admitted that they were being pressured to drop the activity and spend more time in direct patient services.

Dr. Jacobs addressed the team. “You know, folks, we’ve created a seed for something wonderful here. We are just going to have to negotiate our way into something bigger—bigger for us and for the institution. A strong influence we have for change right now is the ACGME Core Competencies. How can we work with that? I’ve also heard that the medical student clerkship directors are interested in applying for a grant in interdisciplinary women’s health. There must be some way to leverage our joint interests.”

Considerations in planning for the negotiations:

  • How can this team identify the positions, issues, and interests of the hospital and medical school departments that might contribute to supporting such a program?
  • What options should the team consider?
  • What are the standards to which they might refer or upon which they might build attractive proposals and alternatives?
  • What leverage do they have? How can they increase their leverage?

Dr. Jacobs knew that preparation was critical to make a compelling case. She kept a notebook of her negotiation preparation notes. See her notes 

To further prepare for negotiation, Dr. Jacobs and the team for the interdisciplinary women’s health care education program considered the questions outlined above. See their responses

See Dr. Jacobs' resolution

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