The Case for Heads: Buffer for Cultural Differences
In stakeholder discussions with my classes and my clients, we often delve into cross-cultural dimensions that can reflect in different values and motivations. Doing my undergrad in business in the early 90s, cross-cultural management pretty much meant dealing with Japan. Now, in this country – and specifically in supply chain – you likely encounter people from different cultural upbringings several times a day.

To deal with cross-cultural issues, I always ask those with firsthand experiences to share their insight. It is safer to address some prickly stereotypes from the “inside.” This particular dimension of in-group/out-group dynamics creates an opportunity to buffer cultural disconnects (including clashing corporate cultures) by involving someone who can see both sides, and, perhaps more importantly, is seen to be able to see both sides.

Call them “agents” or buffers, due to experience of circumstance, using people in this way can go a long way to smoothing some natural tensions, as well as offering translations, including when “maybe” really means “no,” as can be the case with the Japanese culture.

The Case for Tails: Fight Your Own Fight
One of the case studies that I used this summer in my negotiation class involved a classic showdown between a beleaguered airline and its union. In a recent discussion, a student, who was sitting with me to “negotiate” a portion of the final grade, reiterated his position that management should have used a third-party mediator. The rationale being: no emotions, just facts. It really is simple, or at least was in the student’s mind.

If you have ever been “buffered” in this way, it can actually set off an entire new range of emotions that reflect frustration in not being able to make a case directly and suspicion that the “mediator” (or agent) will not accurately reflect your interests. I wonder, in retrospect, how this student would have reacted if I had appointed a third party to hear his case for an improved grade.

Many times you have to “fight your own fights,” if not for control of the situation then to establish yourself for this and future interactions. Relationships matter.

So what?

The interpersonal side of collaboration can be exceedingly complex. That said, there are some instances where the decisions are clear (e.g., work through someone or address a situation directly). Context can give you an idea, but rarely do we get certainty. Experimenting and taking chances (coin tossing?) can create situations that you can reflect upon and learn from.

Happy reflecting!

The people working in these negotiations must feel like Gary Sinise in Apollo 13 when he is trying to simulate the landing procedure while not exceeding an unprecedented voltage level. In the movie (and the real story), he does it, which provides more evidence that the impossible is attainable when we work together.

What if the impossible is really impossible?

I can guarantee you that the word “impossible” has come up in the discussions and negotiations between Ontario’s hospitals (legally bound to budgets) and funders (LHINs whose job it is to enforce this accountability). I am equally certain that, in the end, some of the things deemed “impossible” were so in actuality, while others were not. The only way to separate the two is discussions (apparently still ongoing in Thunder Bay) that remain open and solution-focussed amid a cloud of rising tension. This is no mean achievement.

Unfortunately, “out-of-the-box” solutions are not always there, but they won’t even be entertained if there is a breakdown in the shared goal, which is getting a sustainable health care system in place. If a situation is truly unmanageable, then there is a responsibility to find a solution together. It demands a different approach than traditional “us vs. them” negotiations. A healthy dose of mutual trust will be necessary for resolutions or re-evaluations.

I am intrigued by the cost savings at Quinte Health Care from implementing third-party (Murphy Walsh) consultant recommendations for improved quality of life for nursing staff. Such experts can add tremendous value in honing systems. Of course, time tells whether the dollar return on these efficiencies will help with the budget shortfall. People also have to embrace the changes, and time also tells whether the changes are actually workable for the staff. One hopes that there is a peppering of “sell” in the “tell” for any change required.

Both doctors and parents, one can assume, have the best interest of the child at heart. But it may be more complicated than that: I recall hearing commentary on an instance in Vancouver–raised in the above article–whereby the parents of sextuplets refused blood transfusions because their Jehovah Witness faith did not allow the procedure. The commentary (I will try to find the source; you will have to trust me for now) was that in such instances, loving parents need to be legally forced, because it allows them to save the child, while also saving religious face.

If, in fact, both parties are focussed on what is truly best for the child, both are responsible and accountable. Parents need to be ready to make their case with more than just “this is what we want” or, worse “this is what our child wants.” With all due respect, it should not take a psychiatrist to determine that a child is unfit to determine the cancer-fighting procedures that they will receive. The medical profession must be granted some degree of trust and authority to make these decisions for people. This sort of latitude should be granted, but also needs to be earned.

Information is everywhere, and Google could probably help find a source to support that a diet of raw vegetables beats chemotherapy or that alternative care in Mexico will be more effective than Ontario hospital care. If these sources of information are being given the nod over what the doctor says, the doctor has some “selling” to do. Understanding the real concern takes time, and usually requires (1) creating a relationship of trust and (2) asking questions. Did the doctors do this? Did they have the time? the skill? Not everyone is going to take a doctor’s word as gospel; nor should they.

Medical research and past results are not the only forms of evidence, but will only be effective if the other party is listening. Fostering a dialogue can get people to open up to some grim realities. It must be a horrible decision to pick between a grueling medical procedure that might help, and a less extreme treatment that almost certainly won’t. That decision, however, should not be the parent’s, and definitely shouldn’t be the child’s!