Welcome back to this week's episode of the PNC Podcast. Taking a really big chance today talking about this subject (10 Practices of the Meeting Maestro). It's rather dull, not very inspirational. But communication is really an important factor, whether you're doing a nonclinical or a clinical job.
Obviously when you're working clinically, you need to communicate with patients, as well as with colleagues and other persons. If you're doing a nonclinical job, you'll be doing the same thing. But you might also be doing presentations, and something that's also very common and somewhat annoying at times, and that is: going to a number of meetings.
In fact, you might be going to a lot of meetings. Perhaps a meeting like this one…
I enter the conference room and take a seat. Four other committee members have already arrived. The meeting is scheduled to begin in about four minutes. As part-time medical director, I'm representing the interests of the occupational medical clinic. At five minutes after the hour, three more committee members have drifted in, but the chair has still not arrived. I'm a bit frustrated because I have lots of other work to do. And we're already running late. On top of that, I don't even have the agenda or the minutes from the previous meeting to look over.
The chair, William, walks in and hurriedly arranges some papers and hands out today's materials. He calls the meeting to order and accepts a motion to approve the minutes, which is quickly seconded and approved. We begin our discussion of the next agenda item. One of the other physician members, Dr. Milton, strolls in, followed by Maggie, the director of one of the clinical departments. Dr. Milton is the associate program director of the internal medicine residency program. Once he and Maggie are seated, William pauses the meeting while bringing them up to speed on what we've discussed thus far.
We continue to move down the agenda. Maggie has opened her phone and is furiously responding to text messages. One of the other committee members provides an update on an action item from the previous meeting. A motion is made and quickly approved. We're now 30 minutes into the one hour meeting, and we've barely made it through the first few items on the agenda. For the next topic, Dr. Milton is clearly not in agreement with a proposal that may affect his residents. I cringe inside as he begins his attack on the proposal with, “I've been practicing at this institution for 30 years. When I was chair of internal medicine, we tried to adopt this approach and it never worked.”
He speaks for another 10 minutes reiterating the same argument at least three more times. At one point, he takes a verbal detour to a totally unrelated, but potentially important topic. Then he suddenly returns to his initial argument, repeating it a fifth time for good measure. As usual, William seems incapable of keeping the group on track. I jump in from time to time to help refocus the committee's efforts. But in spite of that, we fall hopelessly behind.
After grinding our way through about half the agenda items, William suddenly remembers that he's already five minutes late for his next meeting. He abruptly adjourns the meeting, stands, and exits the room. We didn't even get to the issue that I was hoping to speak to. And I'm left thinking that another hour of my valuable time has been wasted.
Learning Bad Habits
This meeting was fictional, but I've witnessed every bad behavior described in this story and many more. Unfortunately, for most physicians, the types of meetings we're used to going to are typically meetings like those at the hospital where we're part of the medical staff. Now, I understand, not all of you are on medical staffs. But for those that are, we go to meetings. The attendance is often poor partly because they're mandatory meetings and they're designed to meet regulatory requirements. And sometimes they get some good work done, but not always. And learning how to run meetings in that environment probably isn't the most conducive to learning good practices or good habits when it comes to meetings.
Today I'm going to talk about an important topic, which can be very helpful for both nonclinical and clinical careers. But if you're in a nonclinical career, you may be spending a lot of time in these meetings. You may be part of a hospital management team. Or even if you're doing some other nonclinical job, such as chart reviews or working for an insurance company of some sort, or working for pharma, you're going to find yourself in a lot of meetings, generally. And you may be ultimately running some meetings.
Again, getting back to my contention that physicians are natural leaders, we're going to want to do a really good job when we start leading those meetings because that's going to be a crucial element of our leadership, and believe it or not, meetings can be a very effective tool that can help us to get to know our teams better, to accomplish important projects and goals, and to make important decisions, so I'm going to talk today about the 10 ways or practices that you can adopt to become a master or a maestro of meetings.
Meetings Are a Communication Tool
Meetings are a fairly unique method of communication. Most of the communicating that we do are usually face to face with patients or with direct reports or other individuals, or we're used to doing presentations and teaching, but a meeting combines features of multiple types of communication in which the chair is in charge, but which sparks conversation and discussion within the meeting in a controlled manner, and so by following certain practices, you can get the most out of your meetings and make sure they're not a big waste of time for those participating including yourself.
Remember that a badly planned and run meeting can be worse than just wasting time or being ineffective. It can be costly and it can leave the participants more confused and frustrated than if they had never attended the meeting. Some of us come to actually hate meetings because we attend so many that are ineffective. They seem to be too numerous in number. They take too long. They waste our time. They take us away from doing the real work that we're paid to do.
Let's face it. If we're paid to do chart reviews or analyze the medical literature or write some kind of promotional material, sitting in a meeting is not generating income. And at the same time, it's costing the organization money because each of the attendees is being paid to be there, essentially.
Let's take an example. What would the cost be? If you take 10 or 12 people away from the duties that they're normally doing to get together, and, let's say, you're paying these professionals $30 to $50 per hour, then each meeting of 10 to 12 or 15 people is going to be creating about $500 or more in uncompensated expense, not counting any preparation time for the meeting. Imagine a larger organization with 50 persons attending just four to five meetings a week. The cost just for the meeting attendance can run into tens of thousands of dollars each month. And this is time that the participants are not actually generating billable hours, if that's the type of work that they're doing.
So how does this happen? Nobody goes into a meeting or an organization that has meetings thinking, “Well, I'm just going to try and waste everybody's time by getting them together and hanging out and talking about things that seem like they're important,” but basically the intentions are good. But there's three primary reasons that they're a waste of time.
Root Causes of Poor Meetings
The first is that they're often poorly planned. Perhaps they're a regular meeting that's scheduled weekly or monthly, and they just keep going in spite of the fact that there may not be important topics to address, or there's insufficient planning for them.
The second big reason is because they're poorly run. You can have all of the best intentions and have everything planned well, but if the meeting isn't run properly, and in a way that I'll describe in a moment, then it becomes fairly ineffective.
Finally, it includes the wrong people. Either because the wrong people have been invited, or because the invitee list is too large and people that don't need to be at every meeting are coming, or the people that really need to present something don't show up, often, times without knowing in advance. And therefore the agenda for the meeting really can't be addressed.
So in a few minutes, I'm going to give you some pointers on how to avoid these missteps and others, but let's step back for a minute and let's talk in more detail about the purpose of a meeting.
There isn't that much that you would do in a meeting, really. You're either getting people together to:
- provide them information,
- brainstorm or come up with a creative solution for a problem,
- discuss an issue and actually make a decision, possibly even by taking a vote, or,
- address a project, either move it along, or complete it.
Now, if we step back to the issue of providing information, this is an important thing to keep in mind. There are obviously many ways to provide information. So unless the people need to get together face to face or online, and need to have a conversation, it might be best to provide that information in another format, possibly a written format, or you could even do a webinar or a recorded video.
The reason to have a meeting to provide information is that it gives you an opportunity to answer questions in real-time, which then often save time in the long run in terms of having to go back and forth in an asynchronous way.
Now, the meeting that includes creative discussion or coming up with creative solutions can be a little out of the ordinary. In this type of meeting, we're just getting together and brainstorming. We're trying to come up with “out of the box” thinking for different problem. And this can be a great reason for a meeting. The importance of this is to be sure that you're taking notes and capturing all of the ideas. These are the kind of meetings that sometimes go into strategic planning or goal setting for their annual planning process.
As far as the typical meeting where you're making a decision, these are often the types of meetings where we're at a committee or a board, whether it's part of your organization or part of a nonprofit or what have you. And information has to be presented and then a vote is typically taken and a decision is made.
Finally, there are some meetings that are part of a project planning process, and I'll probably give an example of this a little later on. But it's not unusual in a large project to have multiple types of teams. Each team meets on a regular basis, depending on what it's addressing, and follows a project plan, completing steps along the way. And then ultimately, each of those teams reports to the steering committee, which is responsible for getting the project completed.
Characteristics of Well Run Meetings
Hopefully, many of us have been to very effective meetings and would recognize when we're part of one. And very well-run meetings seem to share a number of characteristics.
They generally have well-defined goals that answer the questions, “Why are we meeting? What will be true following the meeting that was not true when it started? What decisions will be made? What information will be delivered?”
And these questions need to be answered before the meeting so that the meeting can be focused. The meetings are well-run, which I'm going to talk a little bit further down, and ideally they should be parsimonious.
What does parsimonious mean? I guess technically it means frugal. But the way that I use parsimonious means something that has everything that it needs and nothing that it doesn't need. It's effective. It's getting the job done with minimal or no waste. And that waste could be in terms of time and in terms of involving persons that really don't need to be involved.
It may be hard to believe, but it is possible to use meetings effectively to generate results that are more than offset by their costs, and meetings that people actually look forward to attending. So what are those 10 practices that the meeting maestro uses to create a great meeting?
The 10 Practices of the Meeting Maestro
Well, in my opinion, these are the 10 features that those meetings should have, and the components that should be included in planning a meeting.
Practice No. 1
Number one is the goal of the meeting should be explicitly stated. Now, this can be in the charter for the team that was created and that is now meeting, it could be in a mission for a team, or it could just be stated as the goal of the individual meeting for that day.
Practice No. 2
The second thing is that the agenda, the minutes from the previous meeting if there was one, and other meeting materials should be sent out before the meeting, because that is the only way that participants can prepare for the upcoming meeting so that the meeting can start and end on time, and can address all of the issues that are being listed on the agenda.
Practice No. 3
As I said just a second ago, starting on time, which is the third item. We're going to start all of our meetings on time because that's the only way to honor those who are responsible enough to actually show at the start of the meeting.
Practice No. 4
Number four is the chair is running the meeting, but often talks the least. In most types of meetings, the chair doesn't make motions and the chair doesn't vote. The chair is there to coordinate the meeting, facilitate the meeting, make sure we stay on time, and address the other issues that I'm going to talk about in a minute.
Practice No. 5
Practice number five is to follow the agenda. I'm not saying necessarily that it has to be followed exactly in the order in which it's listed. Shortly before the meeting, the chair should look over the agenda. And if there are three or four out of, let's say, seven or eight topics that are critically important, it might make sense to prioritize those and then table anything at the end if they're not all addressed by the time of the close of the meeting. But again, the point is that we should stick with the agenda and not get sidetracked into issues that, while they may be interesting, really aren't part of the reason for today's meeting.
Practice No. 6
Now, practice number six may be the most important part of this whole meeting process. And that is that the chair controls the meeting, starting by limiting the discussion. There are certain types of meeting attendees who try to derail the meeting or otherwise interfere with it accomplishing its goals, and I'm going to address several of those right now even though they don't all necessarily relate to having to limit discussion.
But for completeness sake, first I'm going to address the latecomers. I didn't mention that earlier when I said start the meeting on time, but I'm going to reiterate that it's important that you start your meetings when they say they're going to start, so that you respect the people that showed up at the appropriate time. My recommendation for dealing with latecomers is to basically ignore them.
I definitely don't think you should go back and reiterate everything that's happened in the first five or ten minutes of the meeting for those that come late. Because then you're just teaching everyone that comes on time to just come late because they don't want to sit through the reiteration and have to go through everything twice. Probably if this is a recurring pattern, then you should have a conversation off line with the person who consistently comes late, and the conversation may be that “It's fine if you come late. Come in. But we're not going to start over. But I'd really appreciate it if you come on time like everybody else.”
Now, the other one that can derail a meeting or make it less than useful and less attractive to attend is the dominators. These are people, and they're very common in a medical staff, but in any type of meeting, these are people who feel they always have an opinion when something is being discussed. Now, it's not always done in a purposeful manner, and I'll give you an example.
When I was on the senior management team at my hospital, we had weekly meetings, and the CEO would typically bring up some new issue for input or discussion, and there were one or two people who always had an opinion. And it was interesting. As we dug into this over time as we were talking about trust and working together as a team, we found that they're just extroverts and creatives who seem to be able to come up with opinions on almost anything in the spur of the moment. If there's a slight pause, they're going to jump in. They're going to start talking.
Now, for those of us who are introverted, more analytical, if that's allowed to go on, then we're not going to really contribute much at all. So the chair needs to deal with the dominators, and I'll talk about how to do that in a moment.
There's also the perseverators. And I don't know if that's really a word. But sometimes people make their point and they keep making their point over and over again. At some point the chair has to step in and say, “Thank you, Dr. Smith. We understand, and let me reframe or summarize your point, and then let's move on and get somebody else's opinion.”
There's also the multi-tasker, and that's just somebody who's being rude. They're in the room, checking their phone, responding to text messages and so forth. And I don't think that should be addressed within the confines of the meeting other than perhaps asking that person to contribute on a specific topic. But that's another issue that should be addressed outside the meeting.
Basically inform the person afterwards or at another time that the members of the team really want their input. So we'd prefer they turn their phone off and participate fully in the meeting.
The PARKING LOT Tactic
Now, before I go into the next type of strategy for running a meeting, I want to mention the use of a very helpful tool, and that's called the PARKING LOT. In fact, the parking lot can be used to deal with the dominators or the perseverators or others who seem to derail a meeting, and that's when somebody brings up a topic that's not particularly germane to the issue at hand, you can stop everything at that point and say, “Hey, this seems to be an important issue and it probably needs to be addressed at a future meeting, so what we're going to do is we're going to write this down on the parking lot list.”
This could be an actual list that's put up on a whiteboard somewhere during the meeting, and as these topics come up, you put them up there to be addressed at a future time. I think it's really helpful to use a parking lot. Sometimes it's just a sheet of paper that you can write things down.
Now, the reality is you may want to address these in the future, but sometimes you just won't. But at least you've stopped the conversation on something that is not to be addressed today on the agenda and get us back on track.
Practice No. 7
Practice number seven that excellent leaders use to run great meetings is to involve everybody, so whether you've got a lot of dominators or you just have people that have more experience, the point is if you're inviting colleagues or employees to a meeting, they should be adding to it unless they're there just to learn as an intern or something like that, so a really good leader will pause every once in a while and we'll say, “Hey, Stephanie, I've not heard from you today. On this topic, I think you'd have some good input. Why don't you tell us what you're thinking?”
That way the introverts or the analyticals, or those that tend to want to think about things more before chiming in will have an opportunity to express their opinions and add to the conversation, and that's what makes some of these meetings really interesting, knowing that you're going to be asked to participate and not just be there as an observer.
Practice No. 8
Now, the eighth practice is to summarize the actions that have been agreed upon at the end of the meeting, so let's say we've made a decision, we've taken a vote, everyone's on board, we're going to proceed with this project or we're going to proceed in this direction, or we've decided we're going to do such and such and bring that back to the next meeting, so it's nice if at the end, the last two to three minutes, we summarize everything that is an action step for the next meeting if there is a next meeting, and that way it's clear, it'll go in the minutes, and then it can be sent out with the other materials before the following meeting.
This is where the accountability can be built in so that these action steps should have one particular person's name next to them as the accountable person, and if they're going to be on the next agenda, that person definitely needs to be there at the next meeting.
Practice No. 9
The ninth practice is to end on time. In fact, if possible, you should complete your work and end even early. Don't think of those last five to ten minutes of free time as social time. Give the participants a piece of their life back and say, “You know what? We've finished everything. Do we have a motion to adjourn? Let's all go back to our offices or whatever we were doing earlier than expected and get some additional work done if that's what we want to do.”
Practice No. 10
And then the last practice, number 10, is to be certain to follow-up at the next meeting with those items that we agreed to follow-up on during this meeting. It's amazing how many times we come to conclusions or assign tasks or decide to do something, and then the next meeting starts all over again in a different spot and there's no accountability and there's no closure on that loop, which is really the ideal way to keep things moving with meetings and projects and things like that.
Remember that one sign of a great leader is one who runs great meetings, and if given the chance to prepare and contribute to them, attendees will look forward to participating in your meetings.
Okay. Let me go over the 10 practices of the meeting maestro one more time.
- The goal of the meeting is explicitly stated.
- The agenda, minutes, and other materials are sent out before the meeting.
- The meeting is started on time.
- The chair facilitates the meeting but does not dominate the meeting.
- The chair follows the agenda.
- The chair maintains control by limiting discussion when needed, and using the parking lot as a tool to do that.
- The chair involves everybody in the meeting.
- The chair summarizes the action steps at the end with accountability attached.
- The meeting ends on time, or even early.
- All of the appropriate actions are followed up at subsequent meetings.
I think I'll end it there.
If you'd like to download a checklist to use when planning your next great meeting, go to vitalpe.net/037download, and I'll send you that simple checklist in exchange for your email address.
Thanks again for listening and join me next week for another episode of Physician Nonclinical Careers.
If you'd like to listen to the premier episode and show notes, you can find it here: Getting Acquainted with Physician NonClinical Careers Podcast – 001