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Ask the expert: As a medical staff leader, are there any decision-making techniques I should be using during meetings?

Medical Staff Leader Connection, October 14, 2009

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Meetings almost always include action items that call for group decision-making. Some action items require creativity and brainstorming, while others require more forceful negotiation and trade-offs.

Effective group leaders must be clear about the type of decision needed for each action item. Following are three decision-making techniques you can use:

• Consensus: Consensus requires unanimous agreement, which is often difficult to attain. Groups and committees usually require consensus only when deciding straight-forward, non-confrontational issues. Reaching consensus often requires all participants to compromise.
• Majority rule: Majority rule is best used when legitimate, informed differences of opinion exist, or when committees need to choose between two or more valid options. Close the issue after voting—don’t allow it to be revisited simply because some participants are unhappy with the outcome. 
• Minority rule: With minority rule decisions, leaders are forced to assert their authority. This decision-making process should be used sparingly, usually in crisis situations. When making minority-rule decisions, leaders should inform and request cooperation from all group members. Explain the thinking that lead to an otherwise unpopular decision, and allow meeting participants to voice disapproval or provide input as long as it is constructive to do so.

This week’s question and answer are adapted from The Medical Executive Committee Handbook, Third Edition, by Mary Hoppa, MD, MBA, CMSL; Albert Fritz, MHA; and Richard Sheff, MD, CMSL.

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