- What is the problem?
- Who is it a problem for?
- What is the effect of the problem?
- Am I prepared to put up with the problem?
- Does the registrar accept there is a problem?
- Is there an underlying reason for the problem?
- What changes are we trying to negotiate?
- What are the consequences if changes agreed?
- What are the consequences if changes not agreed?
- What options are there for addressing the problem?
- Which is the best option?
- Who should deal with the problem?
- Does this create a knock-on problem?
- Is the registrar happy with the outcome?
- Spell out the consequences
- How can the resolution be monitored?
Guidelines for addressing problems
- Use general feedback principles
- Address the problem as soon as it becomes apparent
- Be specific, use examples
- Address the problem not the person
- Express your feelings about the behaviour
- Allow discussion
- Let the registrar suggest solutions
- Appropriate time, place, setting
- Dont use humour
- Summarise
- Spell out consequences
- Arrange follow-up
- Look for hidden issues
| Managing the problem | Example |
| What is the problem? | Registrar is frequently late for surgery |
| Who is it a problem for? | Staff, patients, other doctors |
| What is the effect of the problem? | Patients angry, staff flustered, doctors see extras |
| Does the registrar accept there is a problem? | Yes / no |
| Is there an underlying reason for the problem? | Registrar has to drop child at school |
| Am I prepared to put up with the problem? | Yes/no |
| What changes are we trying to negotiate? | Better time keeping |
| What are the consequences if changes agreed? | On time for surgery Problem at home |
| What are the consequences if changes not agreed? | Late for surgery No anxiety re family |
| What options are there for addressing the problem? | 1. Alternative child arrangement 2. Change surgery times |
| Which is the best option? | Less disruptive to surgery system |
| Who should deal with the problem? | 1.staff 2.practice manager 3.trainer |
| Does this create a knock-on problem? | Possible increased anxiety over family |
| Is the registrar happy with the outcome? | Yes / no |
| Spell out the consequences | 1. Signing up 2. Reference 3. Dysharmony between phct 4. Setting precedent |
| How can the resolution be monitored? | Feedback from staff, patients Discussion in teaching sessions |
Classification of potential registrar problems
| Knowledge | Skills | Attitudes |
|---|---|---|
| Prescribing | Communication | I’m the doctor |
| Emergencies | Consulting | I’m qualified now |
| Surgery protocols | Practical eg min surgery, self education | Time keeping |
| Team roles | Preparation | |
| Red book | On call | |
| Availability | ||
| Dress | ||
| Behaviour | ||
| Flexibility re workload | ||
| Self-confidence | ||
| Motivation | ||
| Organisation | ||
| Delegation |