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Doctors at Work Podcast.

Episode #39

How to hold great meetings. With Adrian Piggott

Mat Daniel


Doctors spend a significant amount of time in meetings, but how productive are they? In this episode, Adrian tells me about the importance of considering why the meeting is being held, what we need to do to meet its purpose, and how this needs to be done. Usually it is best to hold meetings to make decisions or generate ideas;  information giving can often be done better without holding a meeting, but if information giving is part of the meeting then we should try to link it to a decision or idea generation. And hybrid meetings are the hardest to do well!

Adrian is an Organisational Development Specialist. He has worked for 20 years in the voluntary and statutory sector delivering health and social care projects, social inclusion and engagement activities. He has significant experience in the equalities, inclusion and human rights agenda from policy development to engagement and training having been a personal champion and manager in this field. He is an experienced coach, trainer and facilitator. Through creative, supportive and thought provoking approaches he can develop practical and sustainable change for individuals, teams and organisations in the delivery of often challenging subjects. You can find him at or @AdrianPiggott.

Podcast Transcript

[00:00:00] Mat: Welcome to Doctors at Work. My name is Mat Daniel, and this podcast is about doctors’ careers. Today’s topic is how to hold a great meeting. Now, we all spend a significant amount of time in meetings, but how productive are they? In this episode, Adrian Piggott tells me about the importance of considering why the meeting is being held, what we need to do to meet its purpose, and how this needs to be done. He tells me that usually it’s best to hold meetings to make decisions or to generate ideas. But information giving can often be done better without holding meetings. And if you do want to have a meeting about information giving, then it makes sense to link information giving to a decision or to idea generation. And he also, tells me that actually hybrid meetings are probably the hardest to do well. I hope it’s useful.

Welcome Adrian. Tell me a little bit about yourself.

[00:01:05] Adrian: Good morning, Matt. So, my name is Adrian Piggott and I’m an Organizational Development Specialist. Organizational Development is a behavioural science and I work at Nottingham University Hospitals and at NUH we focus on culture, leadership and team working.

[00:01:22] Mat: Thank you very much. So, today we’re having a conversation about meetings and how to have a great meeting. So, what is a great meeting?

[00:01:32] Adrian: Ultimately, a great meeting rather depends on the individuals involved in their perspective. What is it that they want to get from that? So, there’s three types of meetings.

So, I suppose what is a great meeting is one that achieves the aims and objectives of that particular meeting. And that will certainly come into the tips and tools. So, primarily great meetings are either decision making meetings. So, you’re able to make a decision that you weren’t able to make without that meeting.

Some of the best meetings are idea generation or problem-solving meetings. The least effective but potentially still useful meetings are information meetings. So, those are the three, three types of meetings. So, an effective meeting is when every participant walks away with more than they arrived with.

That would be my definition.

[00:02:28] Mat: Okay, So, I’m interested in those three different types of meeting, because I’m thinking the meetings that I’m part of I suppose those decision meetings, they probably tend to be quite small, two or three people in my practice would get together but we have regular department wide meetings which, in your definition, they would be information given meetings.

Predominantly information given meetings rather than decision meetings and okay, So, what, why do you say that those would be the least effective?

[00:02:58] Adrian: So, this comes to the whole sort of philosophy and mindset about meetings, which for me is almost the first tip as well. Okay. If we see that people’s time is a finite resource and therefore extremely valuable, and that doesn’t matter about the grade of the individual or their pay packet.

But obviously, the greater the pay packet, the more that meeting is costing the organization. So, there’s something around. Are there other ways to achieve the particular objective of that information sharing other than bringing people physically into a space, whether that’s online or face to face is that the best use of time to give information?

So, they’re usually the poorest because sometimes when we’re giving information, it’s not relevant to everybody that’s in the room. Actually, in terms of people’s psychology the way that we present information tends to preference certain types of people over others. So, this will come into the tips and hygiene factors of meetings, but the poorest way to give information is telling stuff that people Already know telling people stuff that actually doesn’t engage massively with their day to day and is useful for it and also, information giving tends to be a bit poor because I haven’t had a chance to digest and reflect.

So, therefore, what’s my meaningful contribution here? And did we really need to meet in order to transfer that information? So, I was not saying that information giving meetings. aren’t effective, it’s just commonly they’re the least effective kind of ways, because actually any meeting, whether you’re going as a participant or as the chair, is gathering people together, has such an opportunity, is information giving, and if you’ve got a bucket, So, you’ve got a very set finite amount of meetings, So, there is something about that time hygiene.

So, if we can think about actually, I’ve got six hours of time this week to have a meeting, what’s the most valuable thing that we need to be doing to get there? Is it information giving, or is it actually deep diving deeper into something to make decisions? So, also, we tend to get stuck on giving information for information’s sake.

Whereas actually for me. An information meeting should then ultimately be either a decision-making meeting or an ideas creative meeting. So, that information supports something improving in some way. Okay.

[00:05:41] Mat: Yeah, that, that idea that that there’s information given which isn’t relevant, I think that immediately resonates with me.

Probably also, at national, international meetings, because, you only need to go to a national meeting to realize that, the first half of the meeting, half of audience will listen to, and then at lunchtime, the audience switches over, and, and it’s the second part of the subspecialty, and then, they switch over, because people, it’s not relevant to them, So, I guess maybe that kind of a national meeting is laid on for, you to try and meet everybody’s needs, but the reality is that most people are not going to be interested and I can see your point that, there’s a cost of that.

What about the social aspects of meetings, chatting, getting to know people, having a cup of coffee together where does that fit in?

[00:06:28] Adrian: So, another way of looking at, So, those are the three primary formal meetings. There’s another way of looking at meetings which is about gathering people.

So, why would we gather people? Really, I see the objective of a meeting to build social bonds. It’s a potential effective outcome. So, even when we’re coming to make decisions, be creative and some degrees information giving, if we think about meetings from an outcome focus, So, what are we trying to achieve here?

I think that relationship building should be in every single meeting. So, there’s always an opportunity to learn more about each other. that makes the work we do after the meeting or during the meeting more effective. If you look at meetings as a way of gathering and I particularly refer to a book by Priya Parker, it’s called The Art of Gathering.

It’s a great book and it focuses a lot on that social aspect of if we’re going to bring people together in order to build those relationships and connections. We still need to use the same kind of hygiene approach that we would use for formal business-related decisions. Throwing people together in a room and just hoping that relationships will develop is usually very ineffective time spent.

It’s a bit like networking. Networking is usually… Poor and counterproductive. So, even with a social gathering you would be thinking what’s the outcome that we want from this and therefore how do we need to design it? When we just think, oh we’ll put on a lunch and see what happens, which is quite common if it’s a social gathering it tends not to be particularly inclusive or effective.

Are people really talking at depth about the things that will build relationships? Or do we just spend the whole time just talking about fluff, and actually… Yeah, I know a little bit more about you, but I don’t know much about that person over there. And actually, that’s the person that I really wanted to engage and connect with.

I put social relationship gatherings as a different thing from meetings.

[00:08:36] Mat: And actually, listening to you there, I’m thinking if I were to design a meeting, and the purpose of that was to get people to get to know each other better, then I wouldn’t do that. around the latest financial figures, the latest waiting times, and the latest morbidities and mortalities, it would be a completely different structure in order to achieve that purpose, wouldn’t it?

[00:08:59] Adrian: Yeah, very much. So, it’s all thinking about the purpose. So, why are we coming together? So, I use a why, what, and how approach to every meeting. So, why are we even having this? If we’ve only got a limited amount of time with people, is this the most effective use of that opportunity? Otherwise, it’s a really missed opportunity.

The what is okay. So, what do we need to talk about to achieve that outcome? And then the how, which we, in my tip section is some of the principles that enable that what’s happened well. So, I would say, even in quite a drive. Performance or finance thing, there’s still the opportunity to weave into that as a sub objective.

Actually, building relationships and understanding with other people. And that comes into the methodology that we might use. So, even when you host a party, for instance, and you can use that kind of party fund sort of metaphor for any meeting or gathering of people, which is. The worst parties I’ve ever been to, and I’m sure all of us have been to a couple of bad ones, is where there hasn’t been a lot of thought or planning put into it.

You just throw a load of people together around a meal table, like a restaurant or a party. You haven’t thought about the music, you haven’t thought about the food. Have you really considered the selection of friends that you’ve brought together? Are they really going to connect and belong? What’s the space like?

Or is everybody could just cram in the kitchen? So, every time we gather together, actually being intentional with it is really helpful.

[00:10:35] Mat: And I’ve got to ask about virtual meetings, face to face meetings, hybrid meetings. What would be your thoughts about how they affect the quality of a meeting?

[00:10:45] Adrian: I think, I keep toing and froing on this, and there’s some sort of research that face-to-face meetings can be more effective.

Partly because we are more comfortable in face-to-face meetings with some silence. Also, some more random opportunities to talk come up, which you don’t get online. If a meeting has a pause moment, or a small break, or whatever, what you find is that people will connect and talk about either the business at hand or other business, or even just relationship building, and you don’t get that online.

In terms of actually achieving one of those three things of whether it’s decision making, information, or creative, I find no barrier to meeting, being online as face to face. What about hybrid meetings? Hybrid meetings are the worst, and I would avoid them like the plague. It is, particularly if you’ve got the minority of people online, as opposed to the majority in the room, participation is appalling.

Attention is really low. So, you’ve got massive issues of inclusion. So, I’m, I facilitate loads of times where sometimes there’s somebody online that’s been dialled in nine times out of 10. I’ll even forget that they’re there and they might be typing away. But as the chair. My attention is in the room.

It’s not online. So, I’m not attentive to those online and bringing them in, seeing the comments that they might be doing. So, it’s possible. It just takes an enormous amount of work, and the online people miss those into people conversations as well as all the technical didn’t quite hear that or can’t see things or on one event that I was doing, I didn’t realize that.

They were using my laptop’s computer, and I was standing up. So, for most of the session, the person was just looking at my crotch. Hence, I avoid that at all costs.

[00:12:49] Mat: Okay, So, just a final question about hybrid meetings and then I’ll park them, and I asked that because I think there are an awful lot of hybrid meetings that now take place. So, how can we make them better?

[00:13:02] Adrian: I would say the only thing to make those effective would be, So, you need somebody facilitating the room. We need somebody in a sort of support function that’s ensuring that those online are a being attentive because that’s the problem with not being in the room.

They’re more likely to be distracted by other electronic things. It’s a bit harder when everybody’s on a zoom meeting or emcees meeting because you can see eye contact engagement. You can ask questions. It’s easier for people. online to do what we call social loafing, So, just other distractions come up and their participation drops.

So, the only way I’ve seen that effectively used is you have some sort of co-chair facilitator that is ensuring that the people online are getting the information that they need, the questions that are being asked, and capturing their thoughts and answers. Okay. Generally speaking, I’d say don’t do it. If you can.

[00:14:03] Mat: I hope you’re enjoying the show. If you are, please click subscribe So, you will be notified when new episodes come out. This podcast is part of my mission to help doctors create successful and meaningful careers. You can be part of that mission too by forwarding this show to any one person who you think might benefit from listening.

Thank you. Now on with the show.

Let’s leave the hybrid meetings aside then. I’m interested in great meetings then. So, why are many meetings not great?

[00:14:35] Adrian: So, almost just going back a step personally, I love meetings and I love meetings because they are So, powerful. And I think that, and this comes for me into mindset, is that some of the most important decisions, particularly in healthcare, happen in meetings.

We might be deciding a new process or procedure. We might be looking at errors and issues that are coming up in our performance. We might be making investment decisions. So, all of those meetings can ultimately affect either patient experience, patient outcomes, and to really be dramatic, life or death.

If we invest a load of money over here and not over there, that may affect patient outcomes that lead to early mortality. So, if we think that actually this meeting could have serious implications to it, it raises our attention and attachment to that. We’re more invested in actually we need to make sure that this is a good meeting.

So, certainly the research is There’s loads and loads of studies, and you just look at Harvard Business Review or whatever and it’s a very regular topic So, every industry has this issue and globally and certainly a review of executives Was that they’re spending about 23 25 hours a week in meetings.

So, the kind of studies that came back is from these senior leaders that you would think have quite a lot of power to enforce. Good outcomes from meetings like 65 said 65% said it keeps them from doing productive work. 71 said that it was inefficient and unproductive, and 62% just said that those missed opportunities to connect and bring.

teams closer together around a common agenda. We’re not alone in the NHS around having poor meetings. I think the reason that I love meetings is because I tend to go to very few. And that’s because if I can’t think through, and this is the first tip, which is about your mindset, which is why am I going to this?

And every single meeting I go to, I’m, and it’s, even if that’s a regular meeting. I’m thinking, why am I going to this specific one? What’s the purpose and the outcomes? And in particular, and I had a director that challenged me years ago, and it’s kept with me, is that what is the value you are bringing to that meeting in order for them to achieve the objectives?

And what value are you aiming to get? And if I can’t answer those two questions, I don’t go. I’ll say, oh, send me the information or have you got a question or information you need from me? And I’ll just send it to you. Do I really need to be there? Also, I, it raises up for me a challenge of do I need to be there for all of it or some of it.

So, my time is very valuable. So, if I look at an agenda, which sometimes does not and I decline meetings without purpose because I’m like I’m, I might like you. I know you’re doing important work, but if you can’t articulate why we need to meet. And this happened yesterday. And I said, look, I’m more than happy to meet if you can articulate why we’re meeting.

And the meeting disappeared. And I think that’s why we have bad meetings. Because we do not invest, either as a participant or as a chair. Into the thinking about that meeting. So, a meeting for me is something a meeting where you’re bringing people together is a unique opportunity. And every single time you bring people together is a unique opportunity.

So, how do you maximize that opportunity? When you start to realize people have got a finite amount of time, getting people together is really rare in an effective way. You start to think, do we actually need to do this to achieve the things that we’re thinking about? So, usually, I’d say nine times out of ten, the reason that meetings are poor is because of the lack of thinking that’s been put into it, including participants.

So, they just turn up and I’m like, if you’re moaning about this being a poor meeting, why are you here? What have you just turned up because you got invited? Are you turning up because you think you’re made to? Where is the ownership and responsibility to actually make sure our meetings are effective that we go to?

So, even when I don’t chair. If I see a meeting and I don’t really understand the contribution that they’re wanting from me, I will ask and I will challenge. Why do you actually need me here? Am I the right person for this? And is there another way that we can achieve that without having to come together?

And I can tell you how many times meetings have just disappeared, or people say, oh, actually, yeah, no, if you could just send me some stuff, that’d be fine. So, I think I’ve probably over the years halved my meeting time. And therefore, the meetings I do go to. I can’t over generalize. I did go to some meetings that aren’t fantastic.

But there’s rarely a meeting that I’ll go to where I don’t walk away with something that’s useful.

[00:19:49] Mat: So, I think this is going to be a real shock to many of the doctors listening, because we get invited to a meeting and we go because we’ve been invited, or because there’s an expectation, or because it’s mandatory, we have to attend.

And we need to go there in order to meet our appraisal revalidation things. We get invited, we have to go, and therefore we go. But, what you’ve outlined, how you work is the exact polar opposite to how I think most doctors would view meetings.

[00:20:16] Adrian: Yeah, So, there’s something about ownership and responsibility.

Don’t be a meetings victim. So, even if you have to go to it, there’s not, there’s a three-line whip. You have to be there. You still have an opportunity to nudge it towards outcomes that you think would be of use to that you or them. Just ask some questions. Or a tip I usually use is if you can check your diary and say in a given week or month.

Literally time box, how much time you’ve got for meetings. So, once you calculate that, So, you’ve got 25 hours over a month that you could give to meetings around clinics and other responsibilities. You can then go back to those people in authority saying, look. I’ve only got 25 hours. How do you want me to spend that?

What’s the most valuable? Do you want me to get to this or do you want me to get to that? I can’t do both because I’ve only got 25 hours. And usually that wakes up the invitee the inviter. So, oh, actually, yeah. Actually, it’d be more valuable if you went to that meeting, not that meeting, because we really need your input there.

Actually, most of the time, a lot of people get invited. Because Inviter thinks they should invite that person. But that person might be annoyed if they’re not invited. Or that they have a central role, without thinking about their role in the meeting. Oh, we need to invite X, because they do Y.

Alright, that’s fine. But how will their presence actually help what you’re trying to achieve in that meeting? And again, because I’m a meetings coach, I spend a lot of time with chairs of meetings. The number of times they just stop and go, oh, actually, we don’t need all those people, or we don’t need to be talking about that.

And sometimes we don’t even need to have this meeting. So, I think for the power that doctors have, is that everybody wants them at everything, but usually without thinking why. So, the opportunity every medical colleague has is just to prompt that thinking. Now they might go that’s it. I just need you to be there.

So, whilst you’re in the room, if you haven’t nudged things prior to attending, you can still nudge things in the room about, hang on a sec, there’s a lot of stuff here. I’ve only got X amount of time. What’s the most valuable thing that we could be talking about? So, again, moving from that passive to an active participant role.

[00:22:38] Mat: Okay. So, I’m thinking of we, you talked about asking why in my practice, a lot of the time I get invited to patient multidisciplinary meetings. And for some of those, I do push back and say, what is it? That’s required from me, and you know usually the answer is nothing or my last letter from clinic will do not always but usually that’s the case, But I think if I think of something that’s going to affect everybody that’s listening, every doctor that’s listening They will all have regular departmental or practice meeting.

And most departments will have a weekly meeting or a monthly meeting. And I think GP practices will probably do something similar. And there’s an expectation that that everybody goes, and it is, a kind of a three-line whip. So, I think interesting, a lot of the time people ignore it, which probably gets really annoying for people who religiously do turn up.

Yeah. If the deal is that everybody has to turn up. That’s me. Then certainly I get annoyed when other people don’t turn up. Yeah, because the expectation is that everybody’s there. But maybe the other people are wiser than me because they’ve looked at the agenda and kind of thought Mat’s the only Muppet is going to turn up because, because everybody else has thought, what’s the point of this meeting?

And I turn up because of a sense of obligation. So, maybe that’s given me something to think about, Adrian. Thank you. Okay.

[00:23:53] Adrian: In terms of meeting obligations, again, you can propose. If I don’t come to this meeting this time, how can I still be of service? So, that might be oh This is a critical point on the agenda.

What’s your thoughts? Okay. I’ll send you my thoughts before the meeting Yeah you can still meet your applications without being in the room.

[00:24:14] Mat: Okay let’s think on move on to tips for having good meetings. And I know that you’ve outlined some already. And I really like this idea of, asking what, why, what’s the purpose of the meeting as a starting point, both for whoever’s organizing it and sharing it and whoever’s attending.

So, talk me through some more tips for having a great meeting.

[00:24:38] Adrian: So, I’ll focus on, whilst I’ll focus on chairs of meetings, and I suppose to some extent you’ll all, everybody will chair at least one meeting at some point, even if it’s just a pairs meeting, or just with three people, you can still use the same principles.

But also, I think. What I’d like listeners, watchers, to consider is even if they’re not chairing, how could they nudge those meetings using the principles we’re going to go through? So, first of all, I structure meeting preparation and thinking into why, what, and how. It’s just as simple as that.

So, we have terms of reference, which are usually fairly rubbish, and they only get looked at once every couple of years. And sometimes whilst it creates the boundary of, or scope of, that meeting how it actually influences the meeting agenda each time tends to be quite poor. So, I tend to good terms of reference to a really good baseline.

So, they get the scope particularly what’s powerful about a really good term of reference for this. Which should be really short, by the way, no more than a page, is the purpose and power. So, is this an authorizing meeting or is it a discussion forum? What power does this committee or group have to make decisions?

Because there’s no point in a load of people meeting to try and make decisions that actually they’ve got no authority to make and actually it’s moving on somewhere else. Likewise, meetings where things get thrown into the bucket, which aren’t relevant to the scope of the meeting. And number of times I hear things like, oh, we’ll need to take that offline or, oh no, we’ll pass that on to another thing.

And I’m just thinking in one, because I do meetings reviews. and one board meeting I reviewed. I think I counted, I mean it was quite a few years ago, I think it was about 15 items that got knocked off because either the information wasn’t available, it’s not the right committee, we don’t have the right to make a decision on that right now, or actually this is controversial, let’s take it out of the room.

I’m thinking, how much time have we wasted only to get to the point of someone saying, no, we need to take this outside. So, good terms of reference, create the boundary. Once you’ve got that boundary, park it. And then you need to see each meeting as a unique meeting, even if that you’ve got that frame.

Because every time you should meet, you should think about why are we meeting this time? And another tip that, that I’m going further than recommend, I really ask for is look at the purpose of this particular meeting. So, by the end of this meeting, what would we have achieved that we didn’t have before?

So, you’re very outcomes focused that helps to shape you in terms of, okay, what kind of meeting is this there for? And how are we going to be able to achieve those particular objectives? And who do we need to invite to be able to achieve those objectives? So, the why is really important. We another tip I give, and we use quite a lot in OD is each item also, has an outcome.

So, what is the purpose of this item? I hate agendas where I’m looking down the agenda list and I don’t even know what most of those things mean, let alone what we’re trying to achieve by discussing it. So, there’s three things. On my agendas, I put what. I put why we are talking about that particular item, what’s the outcome we’re trying to achieve.

And then the thing that really helps, and this comes into how you meet tip, but it comes up this point, is what is the question we are answering? So, even if it’s information giving, there should be a reason why we’re giving that information, and is there a discussion point to it? Even if it’s a confirmed challenge, do you agree with the data that’s being given?

How could we use that data usefully after today? It doesn’t matter, whatever seems relevant to that information giving. You’re very outcome focused for the whole meeting. At the top of mine, I actually have the purpose of this, today’s meeting is that we achieve these three things. Then each item services that overall outcome and if it doesn’t service it gets not tough and then you go into the what okay So, if this is what we’re trying to achieve, what are we going to do and talk about in order to achieve that outcome?

So, what kind of meeting is this? What do we need? from participants in order to achieve that outcome? What will participants need to achieve that outcome? So, again, I’m sure we’ve all been to meetings where we need to make a decision on x while we haven’t got the informational data to be able to make that decision.

So, lack of preparation usually means that you don’t achieve your outcome, in which case you part the meeting, or you part the item because otherwise you get very poor decision making. You need to think about for breaking it down into each out each item and the outcome for each item and the question answering.

Then you can start to look at well, who needs to be a room at that time to achieve that particular outcome. So, if I’ve got 20 people. Which is poor meeting hygiene, but if I got 20 people and actually five of those people in that room are able to get something from that item or contribute to that item that either I take it off or I put it at the end of the meeting and say this is the last item is just for five of us.

It’s almost like an AOB extension to the meeting. So, I’m releasing everybody else from there, from that valuable time that’s being committed. When you start to look at the question that you’re trying to answer, it really keeps you thinking about, actually, do we have the authority to even make this decision?

Is this the right discussion that we should be having? In this particular gathering and also, the other thing that it really helps with, which again is for me, a must is how much time do we need to achieve that particular outcome. So, I see, I’m sure all of us see this all the time. You never get to the end of that item.

And you’ve got a meeting that’s absolutely jam packed with items. And all you get is skimming across lots of things. And you end up leaving that meeting with no decisions being made, poor understanding of the information that’s given, or little creativity that’s come out of it. So, when you really, when I coach people on it, they go, oh my god, no, that’s a solid hour conversation in itself.

And we’ve only got 90 minutes. Then either you call something different, or you dump everything else, and you focus on that value. The final tip is around how. Okay, So, you’ve got the why we’re meeting. Why we’re talking about what we’re talking about at every stage of that. What we need to do and what information or people that we need to be able to make that particular outcome achievable.

And then there’s some good how to achieve that. So, what makes a lot of meetings ineffective is we haven’t thought about how people are going to effectively participate. Sometimes that comes down to rules as well. And I’m professionally, I see this a lot with doctors is that they are partially attentive, which is the worst kind of meeting.

So, one person’s got one eye in the meeting and one eye on their emails or messaging. And I’m thinking, we’re talking about something really important here, and you’re not even in the room. Or you toggle, as we call, psychologically which is poor for good quality decision making. So, they make a comment, and then they withdraw, and they go off and do their own emails or whatever it is they’re doing on their laptops.

And then they jump in again, and I’m thinking, you’ve only been half listening. Actually, the quality of your input is quite poor, because you haven’t been attentive all the way through. The other reason that we enforce attentiveness, So, I generally try to encourage people not to have electronics on the table, even a phone, and you can’t just turn it upside down, needs to be in your pocket, because it’s still a mental distraction.

The information that you need should be up somewhere So, you don’t need your laptop for that stuff. And actually, for me, part of the how is giving as much information prior to the meeting as possible. Because I tend to find that if you use that methodology of giving as much information prior to the meeting.

You’ve looked at the agenda, there’s some night, you know what the outcomes are, why we’re talking about these things. And there’s even some clear questions that we need to answer. Even if I don’t dedicate much time to that preparation. It starts to create that cognitive engagement. So, when it comes to the question, actually, bubbling away in my back has probably been some processing going on that’s abuse.

So, therefore, we don’t need to go through papers or presentations in the meeting, which is a poor use of time, actually. The other, there’s a couple of rules I give for ensuring good attention and participation. Really simple, which is rounds. And you can do this electronically, or you can do it in the room.

So, you present what you’re presenting, your case, your argument, your information. Everybody already knows what the question is. My role as facilitator or chair is to go, okay, So, our first question to answer is X. We’re now going to do rounds, which is the first person who wants to contribute. We go to the left of that person, and you have to complete the round before anybody is allowed to interact, ask a question, respond, or dig in.

So, everybody has an opportunity to contribute. Everybody has the opportunity to say, I’ve got nothing to contribute, which happens very rarely. Because what happens is that A, creates psychological safety. Because I’m able to contribute without fear of interruption. Also, I know when my turn to speak is, So, one of the reasons that people don’t participate.

is they’re not sure either way for somebody else to take a breath because they’re hogging the mic or you’re oh is it okay for me to say at this point if you know that you’ve got your turn you are more likely to contribute and so, you complete the round. And again, you have to hold the rule quite fast, hard.

You do not open up a conversation until everybody has had a voice. So, it’s very inclusive. And then you can throw open. So, from what we’ve all heard, what do we now need to talk about? What do we think? What do we need to go back to and ask a bit more questions about? If it’s quite a complex issue that you’re asking people to think about, another tip that I do is you ask the question and get people to write down their answer first.

This is really powerful to avoid groupthink. It’s really powerful around psychological safety because actually I’m getting space to, to write down my particular thoughts before being interrupted by other thinking. As a chair, you also, now know if everybody’s written something down, everybody’s got something to contribute, and if they’re not contributing it and avoiding you, now it’s data to tell you maybe there’s a psychological safety issue that needs to be addressed.

So, it’s extra data. You get much better people thinking of people write down first. Then answer their question, and then you open up. Yeah, I think that it helps just avoid that shooting from the hip thinking as well. So, preparation, give as much information to people prior to the meeting as possible, even if they don’t get the chance to read it much, at least they got it clear questions that we’re trying to answer and then facilitate that equal opportunity by just doing around if it’s really a generative round, you can at least do that twice because actually what you find is.

When you go first, by the time you’ve listened to everyone, you might have changed your mind or added. So, another round gives that extra opportunity.

[00:37:07] Mat: That sounds fantastic, Adrian. Maybe I’ll bring us to a close and perhaps I’ll ask what would be your top tips for doctors at work when it comes to meetings?

[00:37:16] Adrian: To move to being active participants, move away from passive victim, meeting victims into that active ownership of why am I going there? What contribution can I make? If I, even if I’m not leading it, how can I nudge this to be a quality conversation for me and others? And a commitment that you won’t be passive in the meeting, that if the meeting is not meeting your needs in it, don’t switch off and just go, oh I’ll just get all my emails.

Actually go, ask for stop moments. Just say, actually, can we just have a stop and think about what’s being said here? So, use your voice. So, my number one tip, just become active and intentional. And if you don’t do anything else, just look at your diary and think, how much meeting time am I capable of giving to this organization team?

And you stick with that, but you’re very clear about it. So, I’ve only got 20 hours. How do you want me to spend that with you?

[00:38:17] Mat: Wonderful. Thank you very much, Adrian.

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