Here in 2014, where employed physicians are projected to comprise a full 1/2 of the work force by 2021, autonomy has become a quaint, old fashioned memory.

You are probably in the middle of your organizational chart with a boss above you. This person often has a frustrating ability to dictate the specifics of your practice, unless you figure out a way to have some influence in their decisions.

In this article let me show you three keys to managing your boss if you are an employed physician. These are the tools you need to take back some control over your practice.

Have you ever asked yourself this question: “If I am not the boss any more, how do I manage the person who is?”

As an employed physician, you will quickly realize you longer sit at your historical position atop the organizational chart. These days you have a boss above you. Sometimes this person is not even a physician.

This is not a situation where you simply deal with it. You must manage this person somehow if you are going to find any wiggle room to create your ideal practice.

Like it or not, the quality of your relationship with your boss is a huge factor in your quality of life.

• A good relationship can boost you to a thriving practice.
• A poor relationship can lead to burnout and is one of the top three reasons employed physicians quit their jobs.

1. Understand your boss

It is vitally important to understand your boss on two key levels

a) Know their personality and communication style

Is your boss an action-oriented person who wants the bullet points, then makes a quick decision — or a detail oriented, introverted “engineer type” who takes time to make decisions or something completely different? Study them and their communication style very carefully. Pretend you are an anthropologist: carefully observing your boss as a key member of your “tribe.”

Then practice the “platinum rule”: Treat people how they want to be treated.

Match their communication style and personality when the two of you are together. Give them the information and time they want, just the way they want it, especially when you are making a request for change to your work structure.

b) Know their goals and priorities

Your boss almost certainly has a boss. They have their own goals and orders from above. Do you know what their priorities/goals/objectives are? The easiest way to find this out is to ask them directly and take good notes.

It will be much easier for you to get what you need from your boss if your request aligns with one of their own goals. This is the essence of a win-win solution.

• What are their key objectives for this quarter and this year?
• What role do they see you playing in reaching these goals?

2. Understand yourself

You must understand yourself on these same two levels.

a) What is your personality and communication style?

Notice the way you communicate naturally and how that either matches or conflicts with your boss’s personality and style. In most cases you will need to modify the way to communicate to connect effectively with your boss.

b) What are your goals and needs?

If you have created your ideal job description and are using the Venn of happiness process to continuously improve your practice, you will probably have requests for your boss every month.

Winning your boss’s support is often the key to making the practice changes you require. Do your best to align your needs with one of their goals, and create that win-win that pleases both of you. Then ask for what you want.

You may need to negotiate back and forth and be willing to accept a bit of a compromise. Do not let that stop you from getting clear on what you want and asking for it.

3. Manage your relationship

Let’s face it, you can’t actually manage your boss. You are not in the position in the org chart for that. What you can manage is the relationship between you

Think of it this way: Your relationship is like a bank account.

Every positive interaction makes a deposit of good will into this account. You can draw on this balance of goodwill if there is a conflict or problem. If the only time a physician sees their boss is when there is conflict or a problem, you have no goodwill to draw on. It will drive the two of you even farther apart.

The solution: Regular collegial meetings with your boss to make sure you are on the same page. Regular as in once a month or once a quarter.

Here are some questions to ask:

• What are your goals for this quarter and this year?
• What role do you see me playing in those goals?
• How do you evaluate my performance?
• What are the most important numbers for you?
• How am I doing at this time?

Keep working to make deposits in your relationship bank account with your boss. Shoot for a ratio of positive 5:1, meaning five positive interactions to every 1 negative or uncomfortable one. This way your balance with your boss will always be in positive territory.

Down the road: These are also the conversations where you can ask for what you need to keep creating your ideal practice.

Action steps

1. Figure out who your boss is. You may need to start here. This may be a challenge in your organization — especially if your structure has changed recently. If you know who your boss is, skip to step #2. If not, make sure you find out who the organization sees as your immediate supervisor.

2. Begin to observe closely and take notes. Prepare yourself to begin practicing the platinum rule. Get to know exactly how they communicate and make decisions.

3. Arrange a meeting in the absence of any problems or crisis. Call them up and tell them something like this:

I would like to buy you a cup of coffee and get to know your goals for me — and the larger organization — so we are always on the same page. I would like to be a better team player. I know you are a very important member of the team here and I would like to see how we can each do a better job of supporting the other. When can we get together?

Let them determine the place and time then get on your specific question list for the conversation.

4. Create your list of questions. Take some time to write down a list of specific questions for your meeting. Ideally these start with “what” or “how.”

5. Hold the meeting, keep it real and take great notes. Make sure that your conversation adds to your relationship bank account while being real about your concerns when asked. This may be your first collegial interaction, so do not ask for any changes just yet. Set yourself a goal to increase your knowledge base about their personality, leadership and decision making style and goals/objectives.

Get to know your boss as a person too. Do they have children, outside interests or hobbies? Where do the two of you have common ground; maybe with your families?

Take great notes, just like you would with a patient. Always be adding to your knowledge base and building your relationship.

6. Schedule your next meeting. Make a habit of scheduling your next visit with your boss before this one is done — so you always have a relationship building meeting on the books with them before you walk out the door. Quarterly is great. Monthly or every other month is better. Ideally you put the whole years’ worth of meetings on your calendars at once before this first one is over.

7.Get on your ideal job description. Know what your ideal job is. Make a prioritized list of the changes you would like to make in your current job.

8. Build a win-win and ask for it.  Pick the highest priority change you want to make to your practice. Look at it from two perspectives: both yours and your boss’s. Put yourself in their shoes now that you know more about them and their situation.

• Create a solution that will be a win for both of you. Prepare to present this request once the two of you have some goodwill in your relationship bank account.
• Rehearse your presentation: Your significant other is a great person to play your boss, by the way. They usually participate with gusto when invited to rehearse with you.
• Be flexible and willing to negotiate.
• Make sure you have a positive balance in your relationship bank account before you make any requests.

The result

When my coaching clients apply these “boss management skills,” they are often surprised at the flexibility, support and improvement in your working relationship that results. In many cases, things you thought were impossible — like going to part-time or getting additional clerical support for your practice — are immediately available when you present a reasonable request to your boss.

Dike Drummond is a Mayo-trained family practice physician, burnout survivor, executive coach, consultant, and founder of TheHappyMD.com. He teaches simple methods to help individual physicians and organizations recognize and prevent physician burnout. These tools were discovered and tested through Dr. Drummond’s 3,000+ hours of physician coaching experience. Since 2010, he has also delivered physician wellness training to over 40,000 doctors on behalf of 175 corporate and association clients on four continents. His current work is focused on the 7 Habits of Physician Wellbeing. Dr. Drummond has also trained 250 Physician Wellness Champions, and his Quadruple Aim Blueprint Corporate Physician Wellness Strategy is designed to launch all five components in a single onsite day. He can also be reached on Facebook, X @dikedrummond, and on his podcast, Physicians on Purpose.