“Men don’t cry.”

Remembering that admonition from my childhood and living in the world of today is very difficult.

I was speaking to a colleague, talking about my semi-retirement, and the happiness I felt in having more time to do some things I wanted to do. He talked about his work situation, having sold a busy practice to a health system, and how his expectations from the relationship have failed. 56361162He now felt trapped between the loyalty and love for patients, some of whom he has seen for 40 years, and his inability to undo what was now done, the sale of his practice. Tears welled in his eyes.

My consulting colleagues were talking to some physicians about the issues they were having in their health system, and the physicians cried as they explained their frustration with the system, how they felt they were ignored and overridden, but also trapped in their mission to provide care.

What do we need to do to fix systems that seem to work so blindly against us? Where do we draw the line? When do we act, and how can we act?

Most of us decry the killing of 12 people who committed the offense of satire against a religious icon and aren’t going to strap on automatic weapons. But what can we do in our employment situations, work life and in the care of our patients? How do we stop the tears?

Firstly, gather your thoughts. Write them down. Create a list of things that are wrong, and back them up with examples where the wrong created greater problems.

Create a list of ways those things can be rectified without unexpected consequences. If change is needed, outline the steps to change, the barriers to overcome and a plan to advance.

Next, talk to your colleagues. Have lunch or dinner, or meet to talk about these things. Go through the list and refine it. See if there is consensus on the issues.

Here’s the hard part. You may have to compromise so that your list is solid and has support from multiple colleagues. Have a solution and understand the constraints your administrative leaders live with.

Asking for more money to do stuff without a strong reason why and a source for the new money or ways to save money elsewhere is bound to fail. If there are things that won’t cost more or save money, start with those, but always track the savings – you may want to spend them elsewhere.

Have a backup plan. Decide how committed you are to the changes. Decide how strong a stand you want to take, and what steps you will take if you are refused.

Finally, ask for a meeting. Solidify the recommendations, start small, build trust and be collaborative. Listen and if you don’t understand, ask for explanations.

Sometimes, using an outside consultant can help build the arguments, strengthen your recommendations and see alternatives. A consultant can also mediate, without emotion and tears or anger. Use the emotion that brings tears to your eyes to provoke you to action, not frustration.

Be prepared to take the steps you decided upon if you fail. Balance your need to rectify your wrongs against your willingness to do what you committed to if your requested change falls on deaf ears. If the conundrum is here, and you can’t right the wrong, then reconcile yourself to lack of desired change.

Find your satisfaction in carrying on for the sake of your patients and your family. Adjust your thinking, rationalize your situation, and if necessary, cry a bit, because real men do cry, and it does help.