Acupuncture Today – February, 2011, Vol. 12, Issue 02 >> Practice Management

The Art of Negotiating

By Cynthia Pasciuto, JD

When I have to negotiate and I am uncomfortable, I call the feeling "squidgy." To get rid of that feeling of insecurity I assess the situation, and use the Thomas-Killmann Conflict Instrument.

In 1974, Kenneth W. Thomas and Ralph H. Kilmann introduced the five different conflict modes through Thomas-Killmann Conflict Instrument, and devised an assessment test. Knowing what type of conflict handling style you use helps you gain a perspective on your own actions and interpret other behaviors.

The first style most people have come into contact with. Those that use the competing style are concerned for only themselves, not the relationship. Competitors are usually focused only on the money situation - they want it all. Litigating attorneys and hedge fund managers fit into this style.

Collaborators balance both a concern for themselves and the other party's goals. This is a style I tend to use as I find it more creative, and it gets to the underlying issues. Unfortunately, this can also lead to lack of closure, because you are looking for the next issue. Business developers fit well into this methodology.

Compromising is the idea of splitting the difference. People who use this style look for a formula or standard to apply to the conflict. This can lead to a rush to the end stage and not enough negotiating opportunities. Accountants and nurses use this style.

Accommodators have a high concern for other people and want to solve problems. In my personal life, I tend to use this methodology. You can be more than one style, and a lot of people have a personal versus professional style. Being sensitive to others makes accommodators at risk for those types of negotiators who are not concerned for the relationship. Accommodators usually work in the clinical professions.

Lastly, there are those that avoid conflict, dodging any confrontation and opportunities to negotiate. Traditionally, diplomats, police chiefs and surgeons are in this category.

In thinking of these different negotiating methods, I always think of a clinical setting, whether a hospital with its different types of styles from the administration to the surgeons or the patient and practitioner setting. In either situation, acupuncturists need to be prepared for the different scenarios which can happen in their practice.

In a Hospital setting

In a hospital, acupuncturists will need to deal with the administration at different levels. There is the basic scheduling with the assistance of staff, but there is also a legal dimension requiring insurance, ethics, and the best practices of the hospital that need to be followed. Then there are colleagues to deal with, not just possible fellow acupuncturists, but physicians, nurses, and surgeons.

For example, contracts are reviewed by the legal staff. You may wish to buy an electroacupuncture machine, and this would need to be reviewed. The legal staff - assuming they are not litigators - are collaborators, and will need input from you.

If you are an accommodator, how are you going to respond to someone who wants more input and information from you? You need to be prepared to collaborate. To work with a collaborator you want to make sure you have brainstormed some options, and do some research on the topic.

As a Sole Practitioner

In your own office the most important person is your patient. Most times, appointments will go smoothly, but situations can arise because of miscommunication, misunderstanding or different personalities.

A predominant issue is lack of payment, whether a check has insufficient funds or an insurance company has not paid for treatment. This places the practitioner in the awkward situation of being a bill collector. If the acupuncturist avoids conflict, then it can be stressful when the patient is competitive and wants to win, leading to non-payment.

If this becomes evident, then an avoiding style should try to meet the same style, in this case competitive. If that is too uncomfortable then there has to be a shift to another style - comparative, in which there is a "splitting of the difference," in regards to the amount of money owed.

The first step is recognizing what your negotiating style is, and the next is seeing what type the other person is. By doing so your negotiations will improve as will your confidence and reputation.

Cynthia Pasciuto practices law in Massachusetts and has conducted seminars at local community education institutions, the National Whole Health Institute and the New England School of Acupuncture on the topics of marketing, legal, insurance and management basics to provide information and consultation.


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