How to Handle Pushback Without Losing Credibility

If you’ve been in healthcare compliance for any length of time, you’ve likely experienced it—the subtle eye roll when you raise a regulatory concern.

Or, how about a cringy sigh when you mention the word “policy”?

Ever hear comments like “Are you crazy, you want us to do what?” when addressing a new regulatory requirement.

If any of these sound familiar, you’re not alone.

Pushback from operational leaders isn’t just frustrating—it can feel like a downright personal rejection of your expertise. But the reality is, pushback is good for the development of your ideas.

Why?

Because it tests your assumptions—ones that you likely didn’t even know you were making about why they are pushing back.

So how do you handle resistance without losing your credibility?

In this article, I’ll explore just how to do that.

Reframe Pushback as Data—Not Defiance

When healthcare leaders push back, it’s easy to assume they’re being difficult. But often, the resistance actually reveals valuable information about what matters to them—whether it’s priorities, pressures, or competing incentives.

Also, keep in mind that if they are pushing back—at a minimum—that means they’re demonstrating engagement to your compliance program.

And isn’t that what you want from them in the first place?

When it comes to engagement, you have to accept that feedback will include what’s working—and what isn’t—with respect to the compliance initiative you are advancing.

So, how do you maintain a positive perspective in light of pushback?

Instead of reacting defensively—get curious. Ask yourself questions, such as:

• “What’s driving this concern?”

• “What are they risking by saying ‘yes’ to me?”

• “What assumptions could he or she be making about this compliance initiative?”

When you change your mindset to see pushback as data—and not disrespect—your mind automatically shifts from conflict to problem-solving mode.

And that’s the mode where you find a true solution that works.

Regulate Yourself—Before You Respond

Let’s face it, healthcare compliance is emotionally charged work.

First off, you’re often the bearer of bad news. When you layer on the organizational risk involved in our work, combined with the corporate politics of healthcare, well—there my friend, you have a recipe for frustration, stress, and anxiety.

When someone challenges you, your body unbeknownst to you, may respond as if you’re under attack (e.g., tense shoulders, racing thoughts, defensive tone). All completely normal and understandable under the circumstances. Unfortunately, for your career longevity, throwing a fit akin to a toddler just isn’t an option.

Instead, you need to regulate yourself before you respond.

Now, I’m most definitely not a therapist, so I’ll pause and say that you should consult an expert in behavioral health if this is an area that presents a challenge for you. There are endless resources out there with tools that can help improve your ability to stay present and grounded.

What I can say is that if want the tool to be effective— then you have to practice it. Like any skill, practice is the only way to be able to tap into it without having to think about it. 

Aside from grounding tools, another way to help regulate yourself is re-centering by internally reminding yourself:

“The focus of the concern isn’t about me, it’s about resolving the issue.”

When you can effectively manage your emotions in a high-stake moment, you send a message to your leaders that you’re someone they can rely on. Over time, this helps earn their trust. 

Acknowledge their Concern—Before You Verbalize Yours

When leaders feel unheard, they dig in deeper. One of the quickest ways to defuse tension is to validate their perspective. For example, you could say something like:

“I hear what you’re saying. This regulatory change will definitely have an impact on your department’s workflow. What if we look at this together to see how we can make it manageable for your staff, while still meeting the organization’s regulatory obligations?”

Acknowledging their concern is not about agreeing with their position. Rather, it is placing value in their opinion, while preserving yours. When you take this approach, it puts you in a much better position to maintain the relationship and keep the conversation productive towards a solution. 

Follow Up Strategically

As a final measure, circle back with the leader once emotions have settled. From a practical standpoint, this looks like summarizing any agreements from prior discussions, outlining next steps, and confirming mutual understanding with all the parties involved.

This will not only help you overcome pushback, but reinforce your professionalism and keep the momentum on your side towards a workable solution.

Handling Pushback and the Politics of Healthcare

Pushback is part of the political landscape of healthcare that we must navigate on a daily basis. The key to being an effective compliance officer, is knowing when—and how—to read the social cues around you.

For example, it may be that the reason a department director is pushing back is because it doesn’t align with a performance goal promised to a supervisor—or a board. It could also be because of a power struggle between two people that has nothing to do with your initiative.

So pay attention to the political landscape around you. That includes being self-aware to things like how decisions are made in the organization, who has the ability influence the decisions of others, and who gets along with who.

Handling pushback well shows your operational leaders you’re not just a rule enforcer—you’re politically savvy. You understand timing, tone, and influence. You know when to push, when to pause, and when to pivot. In other words, managing pushback effectively is a form of political intelligence. It helps you build the relationships and trust you need in order to get your compliance initiative heard instead of ignored.

Pulling it All Together

Pushback is inevitable—but it’s not a setback. It’s an opportunity to demonstrate emotional intelligence, political awareness, and strategic communication. Overtime, these are traits that will help you gain credibility with your operational leaders.

When you handle resistance with composure and credibility, you don’t just preserve your reputation—you strengthen it. Over time, that’s what turns compliance officers into trusted advisors who can navigate the politics of healthcare with confidence and impact.

So, see—pushback isn’t a threat. It’s actually a good thing that will help you elevate your career.

---

Are you a new healthcare compliance officer?

Feeling isolated from your healthcare leaders?

Unsure how to get them to care about compliance?

It's not about how much you know.

It's about how you communicate what you know.

That’s exactly why I created How to Successfully Sell Compliance to Healthcare Leaders.

𝐘𝐨𝐮𝐫 𝐫𝐞𝐠𝐢𝐬𝐭𝐫𝐚𝐭𝐢𝐨𝐧 𝐢𝐧𝐜𝐥𝐮𝐝𝐞𝐬:

• The complete interpersonal communication framework & tools

• Lifetime access to the course materials

• Personalized instructor support

• Access to an exclusive student community

• Self-study CEU credits available

Compliance education teaches you about the rules, but no one teaches you how to get leaders to care about them.

This training fills that gap.

---

Did you find this article helpful?

If so, check out my book.

It contains authentic relationship-building strategies to help improve engagement in your compliance program.

NOTE: Bulk order discounts are now available—contact me at janstine@bluebirdhealthlaw.com for more details.

The Art of Framing: How to Present Compliance as a Solution

For early-career compliance officers, one of the biggest challenges isn’t understanding the regulations—it’s learning how to frame compliance in a way that healthcare leaders actually want to support.

Too often, compliance is seen as the department of “no”—ya know, that mythical place where good ideas go to get shut down. The truth is, compliance can be a strategic partner that helps the organization achieve its goals sustainably—and compliantly. The difference between those two perceptions though depends on how you communicate your compliance message.

Framing is the art of positioning a communication so that others understand how it helps them succeed. When done well, it shifts perceptions, builds trust, and opens doors that otherwise stay closed.

In this article, I’ll cover how to use framing in order to position your next compliance initiative as a solution, and not a barrier.

Start With Their Goals—Not Yours

Before you talk about compliance requirements, talk about what matters to your audience. In my experience, healthcare leaders make decisions based on three things: risk, relationships, and results. More specifically they’re focused on things like: patient outcomes, business strategy, financial performance, and staff efficiency.

If you start your message with “The regulation says…” you’ve already lost them.

Instead, begin with their priorities. For example, you might try something like:

“I know you’re trying to reduce denials and document efficiently. As it relates to (insert the departmental process at issue), here’s a way I can help you with that.”

When you frame compliance within the context of their goals, it demonstrates alignment to them, rather than opposition. From the perspective of your audience, it makes your message more relevant and less adversarial.

Recast Compliance as a Strategic Business Advantage

If you follow Ross Ronan of Ronan Healthcare Consultants, then you know, he is a huge proponent of framing compliance to healthcare executives as a strategic business advantage.

And Ross is right.

Every organization has strategic objectives — growth, reputation, quality, and innovation to name a few. What often gets overlooked by leaders is that compliance supports all of these objectives—that is, when positioned correctly. For example, when your organization is in the business of patient care, trust is a market advantage. Relatedly, an organization with a strong culture of compliance signals to patients that the organization is a safe and ethical organization to do business with.

Since that example is a little high-level, let me give you another one closer to your work. Let’s assume you’re in a meeting to discuss the launch of a new service line. In that scenario, framing compliance as a market advantage might look like saying:

“I can help set guardrails to ensure (insert the new service line) is built on a solid foundation that can withstand regulatory scrutiny from an auditor or investigator.”

When you reposition compliance from looking like check-the-box to a strategic business advantage, you shift their mindset from being viewed as a regulatory burden to an enabler of organizational success.  

Use Language That Invites Collaboration

Let’s face it, words matter.

When I was in law school, I had a professor who use to tell us, “Students, your craft will be defined by two things: your time and your words. Choose them both wisely”. While our profession is not the practice of law, I think the message equally applies to our work.

Compliance-ey phrases like “we can’t do that” or “that’s not compliant” shuts down dialogue—and like—real fast. Instead, you want to use language that invites collaboration, such as:

• “Here’s how we can do that within the rules.”

• “Let’s look for an option that meets both our operational and compliance needs.”

• “We can accomplish the goal — we just need to make sure the process is structured the right way.”

This subtle linguistic shift keeps you positioned as a problem solver, not an obstacle. Over time, it also builds your credibility and respect as someone who understands the realities of the organization’s business.

Tell the Story Behind the Rule

Whether it’s delivering education, investigating an issue, or conducting an audit, everything you work on has context around it.

Everything.

Sometimes referred to as, “the why”, providing context helps your leaders understand the reasoning behind your message that compliance matters. For a compare and contrast, consider the following example:

Framing compliance through context appeals more directly to your leaders’ sense of responsibility and aligns with the organization’s mission and values.

Framing and The Politics of Healthcare

In the political landscape of healthcare, perception often shapes influence. Even if your compliance recommendations are technically correct, how you frame them determines whether leaders view you as a partner or a problem.

By framing compliance as a solution, you achieve three goals towards effectively navigating the politics of healthcare:

• Strengthening alliances with your operational and clinical leaders.

• Reducing resistance and defensiveness towards the compliance program.

• Positioning yourself as a trusted advisor who understands the business.

When your healthcare leaders see compliance as something that helps them achieve their goals, you gain access, trust, and best of all—a seat at their decision-making table.

Pulling it All Together

In a world where corporate politics and competing priorities are constant, how you frame compliance determines whether your message lands — or gets lost. Simply put, knowing the regulations makes you competent, knowing how to influence makes you effective.

Framing isn’t just for big presentations — it’s a mindset. You can apply it in every meeting, email, and conversation.

Compliance officers who master the art of framing don’t just get better results — they change the culture of compliance in their organizations. They move from being seen as enforcers to being recognized as leaders who drive integrity, collaboration, and strategic success.

So the next time you share a compliance recommendation, ask yourself—“Am I presenting this as a roadblock, or as a path forward?”

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Myth: Healthcare leaders don’t care about compliance.

Truth: They do care—but they need you to frame it in a way that connects to their priorities.

How do you do that?

I’ll show you how in—𝐇𝐨𝐰 𝐭𝐨 𝐒𝐮𝐜𝐜𝐞𝐬𝐬𝐟𝐮𝐥𝐥𝐲 𝐒𝐞𝐥𝐥 𝐂𝐨𝐦𝐩𝐥𝐢𝐚𝐧𝐜𝐞 𝐭𝐨 𝐇𝐞𝐚𝐥𝐭𝐡𝐜𝐚𝐫𝐞 𝐋𝐞𝐚𝐝𝐞𝐫𝐬.

𝐘𝐨𝐮𝐫 𝐫𝐞𝐠𝐢𝐬𝐭𝐫𝐚𝐭𝐢𝐨𝐧 𝐢𝐧𝐜𝐥𝐮𝐝𝐞𝐬:

• The complete interpersonal communication framework & tools

• Lifetime access to the course materials

• Personalized instructor support

• Access to an exclusive student community

• Self-study CEU credits available

Compliance education teaches you about the rules, but no one teaches you how to get leaders to care about them.

This training fills that gap.

---

Did you find this article helpful?

If so, check out my book.

It contains authentic relationship-building strategies to help improve engagement in your compliance program.

NOTE: Bulk order discounts are now available—contact me at janstine@bluebirdhealthlaw.com for more details.

Five Ways To Support Your Compliance Supervisor

Starting out as a healthcare compliance officer can feel overwhelming.

You’re expected to know the regulations, understand the culture, and demonstrate your value to leaders—all while figuring out how to fit into the corporate politics of the organization. One of the best ways to accomplish all three is to keep the following perspectives in mind when it comes to anything you’re working on:

1. The task in front of you and the steps you need to take to resolve it (...pretty obvious).

2. How to make your supervisor’s job easier as you resolve the matter (sometimes overlooked).

In this article, I will cover five key areas that will help you—support your supervisor more effectively.

1. Anticipate Issues Before They Escalate

Seek to avoid only reporting problems after they have occurred. Here, you want to flag potential risks early, while at the same time—and I can’t stress this enough—proposing practical solutions.

What’s the “Why” Behind it?

• Learning to be proactive early shows your leader that you can think like a risk manager—not just a rule enforcer.

2. Communicate Clearly and Concisely

Using executive-level updates like SBAR or IRAC will help your supervisor quickly grasp the issue without wading through details and asking questions.

 (Actually, let me re-phrase that...they’ll still ask questions, but it’ll help reduce the number of questions you get asked.)

 What’s the “Why” Behind it?

• Knowing how to connect an issue to organizational risk, or logically sorting out complicated facts will demonstrate your leadership skills to be efficient with their time. In the long run, it will help you build credibility and influence.

3. Prioritize Your Needs Based on Organizational Risk

In this line of work, everything appears urgent at first glance. Unfortunately, the reality is some things are truly urgent to the organization—while others have to wait.

 So how do you know which is which?

Ask yourself, “Is this ______ urgent for me, or the organization?” You can also help your supervisor focus by ranking issues upfront (e.g., high, medium, low risk). This way, they know what truly needs their attention now versus what can wait.

 What’s the “Why” Behind it?

• Learning to prioritize demonstrates maturity and helps your supervisor trust your judgment. One of those unwritten rules—but something I guarantee you is taken into consideration when it comes to promotions.

4. Keep Them Out of the Weeds & Independently Problem-Solve

If you’re faced with a routine compliance task (e.g., what questions to ask or where to find an answer), be as independent and self-sufficient as you can be. Additionally, when it comes to problem-solving, be mindful not to fall into the trap of letting your supervisor take the lead because it feels easier. For example, instead of saying “There’s a problem with these physician payments under the contract, what should we do?”…try saying, “I have reviewed the physician payment documentation, as well as the contract, and here is what I think we could do to resolve this matter compliantly.”

What’s the “Why” Behind it?

• Knowing when to handle things independently builds confidence for you—and your supervisor. It also frees up their time to focus on strategy and leadership.

5. Protect Their Reputation

Watch out for your supervisor by double, or sometimes, even triple-checking your work for accuracy before it leaves your desk.

What’s the “Why” Behind it?

• While occasional mistakes will happen, if it becomes a pattern, it can affect your supervisor’s credibility with leadership. To safeguard that from happening, take time to slow down and do your due diligence. There is no prize for being the fastest to resolve an issue that I’m aware of.

Pulling it All Together 

Supporting your supervisor isn’t about doing more work—it’s about working smarter. It’s about seeing the big picture and aligning your efforts so that you and your supervisor succeed together. While not intended to be an all-inclusive list, the above strategies provide a solid foundation to help position you as a trusted partner, while earning credibility for a bright future.

---

Are you a new healthcare compliance officer?

Feeling isolated from your healthcare leaders?

Unsure how to get them to care about compliance?

It's not about how much you know.

It's about how you communicate what you know.

That’s exactly why I created How to Successfully Sell Compliance to Healthcare Leaders.

Learn in a few hours what takes others years to figure out on their own.

---

Did you find this article helpful?

If so, check out my book.

It contains authentic relationship-building strategies to help improve engagement in your compliance program.

NOTE: Bulk order discounts are now available—contact me at janstine@bluebirdhealthlaw.com for more details.

How to Handle After-the-fact Compliance Reporting

As a new healthcare compliance officer, one of the more frustrating challenges you’ll face is when operational leaders notify you about a potential compliance issue only after it’s already occurred—sometimes days, weeks, or even months later.

When this happens, you’ll find yourself thinking:

“Why didn’t they loop me in sooner? I could have helped them prevent this.”

This situation is more common than you might think—and it doesn’t always stem from bad intent. Often, leaders are juggling competing priorities, unsure if something is a compliance issue, or simply unaware of the importance of timely reporting.

So what can you do about these moments that are real and fun, but not real fun?

Below are five practical strategies that will help.

 #1: Respond with Curiosity—Not Criticism

When a leader brings an issue to you in this manner, it’s tempting to react with frustration—but resist the urge. Instead, approach the conversation with genuine curiosity. For example, you could try asking questions like:

• “What made you decide to bring this forward now?”

                                         or

• “Is there anything I can do to help you report this type of issue earlier in the future?”

In the short-term, taking this approach keeps the communication open, avoids defensiveness, and helps you understand what barriers might have delayed the report. In the long run, it helps you establish rapport with your leaders, which in turn, will make them feel more comfortable speaking up when issues arise down the road.

 
#2: Reframe Compliance as a Support Function

When I talk with healthcare leaders hypothetically about a reluctance to report, some of the biggest reasons why include: fearing blame, decision-making bureaucracy, or being told “no.”

You can help change this perception by repositioning compliance as a partner and not a policing function. For example, you could emphasize that your role is to help them make the best business decision and ultimately protect the organization from unnecessary risk.

You can also highlight that reaching out for advice before going live with a new business venture will help them avoid costly mistakes if they go it alone.

Lastly, using language like “Let’s figure this out together” instead of “This is illegal” will send a message that compliance is a business partner and not an obstacle.

 
#3: Create “Safe Zones” for Sharing Concerns

If leaders don’t feel psychologically safe to admit something went wrong, they’ll delay or avoid disclosure. You can counteract this dilemma by proactively creating low-pressure ways for them to raise issues early.

For example, you could try offering 15-minute “compliance check-ins” where leaders can ask questions informally, or continually message to them that you are available to talk through any concerns privately if that would make them feel more comfortable.

Another approach you could take is when someone shares a scenario with a compliance concern, respond with: “That’s actually something we’d want to look at early from a compliance standpoint.”

Finally, it’s worth pointing out that even proactively using the words “this is a safe space” can help put them at ease. Just make sure if you say it, you intend to act on that promise.

While not intended to be an all-inclusive list, these are just a couple examples of how you can create a safe zone to encourage leaders to more proactively report issues.

#4: Offer Real-Time Micro-Education

Sometimes late reporting is simply a result of not recognizing a compliance issue in the moment, so be mindful of that potential knowledge gap.  

To bridge the gap, there are a few steps you can take. First, educate early and often that your role is designed to help them interpret what is—and is not—a compliance issue.

Also, part of your ongoing message to leaders should be emphasizing the importance of reporting concerns to you proactively instead of reactively. Here, to ensure the message lands with your audience, provide hypothetical examples that outline how little problems can snowball into big ones.

Finally, another approach you can take is to highlight how an issue could negatively impact them if not addressed (e.g., loss of trust and reputation, potential corrective action, financial impact to organization).  

Since new leaders come and go, one thing you need to accept is that this type of education will need to be repeated on an ongoing basis to reduce instances of finding-out-after-the-fact.

 
#5: Recognize and Reinforce Early Reporting

When a leader does bring an issue to you promptly, celebrate it. For example, you could say, “I want to thank you for having the awareness to identify this as a potential compliance issue and report the matter. Since I can’t be everywhere-at-all-times, it takes this type of dedication from operational leaders to help make our compliance program effective.”

For this particular strategy you can also try the following approaches:

• Thank them privately or publicly, depending on the situation.

• Share the story (anonymized if needed) as a “win” in a leadership meeting.

• Say things like: “Because you brought this forward early, we were able to… [insert good outcome].”

In my experience, positive reinforcement is one of the most effective ways to encourage the behavior you want to see with your operational leaders.

Pulling it All Together

Late reporting can feel like a setback, but it’s also an opportunity. Every time a leader brings something to you—even if it’s after-the-fact—you’re building trust. With consistent messaging, positive reinforcement, and a partnership mindset, you can shift the culture toward proactive compliance engagement.

Keep in mind that you can’t solve this challenge overnight—so just start by laying the foundation—one interaction at a time. Eventually, this approach will result in increasing their awareness to proactively engage you. As your relationship strengthens with your leaders, they will feel more comfortable coming to you.

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You know the regulations. But do you know how to make your leadership team listen?

Many healthcare compliance officers—especially in their first ten years—struggle with being heard.

The problem isn’t your expertise.

It’s how you communicate with healthcare leaders.

That’s exactly why I created this new free training—Why Healthcare Leaders Resist Compliance—And How to Change That.

Let's level up your game together.

To sign up, click on the link below…

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Healthcare leaders make decisions based on three things:

• Risk

• Relationships

• Results

In my course, How to Successfully Sell Compliance to Healthcare Leaders, I’ll show you exactly how to translate your message into what leaders care about—and how to build the kind of relationships that open doors instead of shut them.

Now you can learn in a few days what takes most other compliance officers years to figure out on their own.

---

Did you find this article helpful?

If so, check out my new book.

It contains proven relationship-building strategies to help improve buy-in to your compliance program.

NOTE: Bulk order discounts are now available—contact me at janstine@bluebirdhealthlaw.com for more details.

A Compliance “Power” Move: Staying Neutral

 “Commerce with all Nations, alliance with none should be our motto.”

- Thomas Jefferson

Several years ago I stumbled across that quote while preparing for a conference presentation. I think that it perfectly illustrates the role that we as compliance officers have to play when it comes to navigating the corporate politics of healthcare.

It’s tempting to get sucked into interdepartmental disagreements and personal drama when you’re carrying out your compliance work, but my best advise would be—“don’t do it”.

Your best course of action is to do the “commerce” part of the quote by focusing on working with everyone in the organization without an attachment that you’re on someone’s side. Remaining neutral helps you build trust that you have the best interests of the organization at heart.

So what does neutrality look like in the context of a healthcare compliance officer? 

In this article, I’ll cover the interpersonal communication strategy of staying neutral and why it is important to navigating the compliance program through the corporate politics of healthcare.

Defining a Neutral Position

Generally speaking, “being neutral” means functioning independently and objectively in how you approach your compliance work. That is, the way you show up is being nonjudgmental. It also means treating everyone you interact with in the organization with the same level of respect as you perform your duties. If a corporate analogy will help, think of compliance in the organization like that of HR, who similarly must function irrespective of special interests.

So from a practical standpoint, how do you maintain a neutral position within the organization? 

Below are three strategies that have helped me over the years.

Strategy #1: Approach Your Role as Independent

If you want to be viewed as a neutral party in the organization, then you must approach your role as being independent and objective, regardless of what you are working on. For example, if you are conducting an investigation, being independent and objective means you are giving all parties involved an equal opportunity to be heard. You’re also allowing each side the chance to explain their version of events, free from judgment. In the context of investigations, it also means clearly communicating to all parties involved that no decision will be made about the investigation until all the facts have been gathered.

Being independent and objective also means you are assuming neutral intent with others until your facts establish otherwise. That is true whether you are working on an investigation, an audit, or consulting to a healthcare leader about a proposed business venture. 

When you take this approach, you are maintaining a neutral position by not judging others or jumping to a conclusion.  

Strategy #2: Avoid Destructive Politics

Within healthcare, there are corporate politics all around us. Hospitals and physicians in conflict, department staff at odds with other one another, and even patients unhappy with their providers. If you want to be viewed as a neutral party in the organization, then you have to avoid playing destructive politics.

What are destructive politics?

They are actions and words intended to solely promote oneself. Productive politics, on the other hand, are actions and words intended to promote the organization, regardless of who personally benefits.

What does productive politics look like for a healthcare compliance officer?

• Investigations: Investigate or audit when it is in the best interest of the organization, and not to make an example of an employee or a department.

• Accountability: If you are holding staff accountable for completing training or following a policy, hold those discussions confidentially with the employee and his or her supervisor, and not in front of the employee’s co-workers.

• Recognition: If someone has put work into a process improvement, openly recognize that person rather than taking credit for their work.

 By focusing on productive politics and not destructive ones, you will improve your ability to stay neutral in the organization with respect to accomplishing the goals of your compliance program.

Strategy #3: Avoid “Us vs. Them” Communication

If you want to be viewed as a neutral party in your organization, avoid an “us vs. them” mentality when communicating with others. While a competitive mindset helps in professional sports (think Yankees vs. Red Sox), in organizational communication, it can damage the organization’s culture of compliance. 

Several years ago, I had an issue surface with ensuring physician orders were in place for billing out high dollar imaging procedures. We discovered through an audit that there were missing physician orders for the services provided. After refunding payments from the claims we were paid, we needed to implement process changes to ensure the documentation was in place. The scheduling department argued it should be the responsibility of the registration staff.

And guess what?

The registration staff argued it should be the responsibility of the scheduling staff. 

(Shocking, I know.)

As the compliance officer, my goal is to ensure the organization has processes in place to meet the regulatory requirement.  As such, it would not be in my best interest to “pick a side” in this battle. (e.g., “The scheduling department is always trying to get out of taking on more work.”) Instead, my communication had to be independent and objective. I need to understand the concerns of each side without judgment, and identifying a solution that both departments can accept. 

In the end, we were able to resolve the disagreement by requiring both sides to play a role. The scheduling department had to implement a verification process before the exam was scheduled, and the registration staff agreed to verify that the process was completed.

By taking this approach, your actions and words will match that you are functioning like a neutral party in the organization.

The Importance of Staying Neutral

Like any industry, healthcare is political because the industry workers play games in order to get what they want. When it comes to navigating the compliance program through the politics of healthcare, taking a neutral position in the organization is helpful for a couple reasons. First, it helps you establish trust and credibility which helps you build strong relationships with others in the organization. Also, when you know how to communicate in a way that is respectful of others, it allows you to diplomatically influence them in a way that supports the compliance program and resolve conflict.

Pulling it All Together 

When it comes to how you approach your compliance work, it will be in your best interest not to play favorites with any particular individual or department.

Remember, “Commerce with all Nations, alliance with none” should be our motto.

When you maintain a neutral position in the organization, you remove the potential for others to question your independence and objectivity. The old saying goes that if you want a healthy culture of compliance, then you have commitment throughout all levels of the organization to do the right thing—and doing things right.

If that is the level of culture you want, then you have to reciprocate a commitment in how you treat others—throughout all levels of the organization.  

---

 You know the regulations. But do you know how to make your leadership team listen?

Many healthcare compliance officers—especially in their first ten years—struggle with being heard.

The problem isn’t your expertise.

It’s how you communicate with healthcare leaders.

That’s exactly why I created this new free 30 training—Why Healthcare Leaders Resist Compliance—And How to Change That.

To learn more, check out the link below…

---

Healthcare leaders make decisions based on risk, relationships, and results. 

In my course, How to Successfully Sell Compliance to Healthcare Leaders, I’ll show you exactly how to translate your message into what leaders care about—and how to build the kind of relationships that open doors instead of shut them.

---

Did you find this article helpful?

If so, check out my new book.

It contains proven strategies to help you navigate the compliance program through the politics of healthcare.

NOTE: Bulk order discounts are now available—contact me at janstine@bluebirdhealthlaw.com for more details.

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How to Navigate Grey Areas With Confidence

Working with uncertainty is something that compliance officers face on a daily basis. For example, regulations and policies are often written to cover many scenarios—except for the one that’s right in front of you. 

Am I right?

In the business of healthcare, operational leaders seek clear-cut answers, but sometimes it’s a struggle to find a definitive one and feel settled in the process. While navigating grey areas can be tricky, this article will cover four strategies that can help you become more comfortable in the face of ambiguity—and relatedly, make your leaders feel the same way.

#1—Understand All Points-of-View (POV)

Here, you want to factor in the feedback, insights, and opinions of others—including the ones that differ from your own. While, that may sound like a no-brainer, let’s dig a little deeper.

In my experience with navigating the corporate politics of healthcare, I have found that understanding POV means knowing an individual’s position and interest. Relatedly, it becomes important to recognize the difference between the two. 

A position is what someone says they want. For example, a COO says “We want to partner with this physician group to bring a new service line to our patients”. An interest on the other hand, is “the why” behind whatever it is that they want. In this case, let’s assume the COO is seeking to fulfill a performance goal established by the CEO. Positions tend to be communicated, whereas interests are often hidden. To that end, if the interest is not publicly known, you may have to dig for it by identifying it with the individual offline.

If learning how to understand POV is an area you wish to improve, here are some tips that will help:

• Listen to Understand. Take the time to listen to different perspectives in order to understand where others are coming from (i.e., identify the positions and interests).

• Practice Empathy. Put yourself in the shoes of others to better understand their perspectives and motivations (e.g., how might I interpret this regulation as a COO who wants to do the deal). 

• Ask Questions. To identify an interest, consider asking questions such as, “From your perspective, what will happen if we’re not able to resolve this issue?”

2—Evaluate the Consequences

In the world of healthcare compliance, decisions matter. When you consider the business of healthcare is highly regulated, heavily rooted in logistics, and deeply personal when it comes to serving patients—the stakes are high.  

Whether it’s navigating a regulatory change, choosing how to respond to a HIPAA violation, or determining the scope of an audit, our actions can have ripple effects that extend beyond the immediate issue. To that end, compliance officers need to be thinking about questions like: 

• What is the risk to organization (e.g., legally, financially, reputationally)? 

• What is the risk to patient care?

• What is the risk to my job, my supervisor’s job, and on up the organizational chart?

The unfortunate reality of our work is that it takes time to develop the skills needed to evaluate the consequences of different actions. That said, here are some tips that can help:

• Consider Outcomes. Think about potential outcomes and weigh the consequences of different actions.

• Find the Balance. Consider what is required, along with what is ethically sound and operationally feasible— that means taking a moment to ask, “What happens next if we choose this path?”)

• Discuss With Your Supervisor. Talk with your supervisor about these questions and your responses—before you act.

This strategy could be summed in four words—“consider the big picture”. If this is an area that you struggle with, then check out a companion article I wrote a couple years ago about taking a big picture approach to compliance.

#3—Engage in Critical Thinking.

While knowledge of the regulations is undoubtedly essential to our role, there is one skill that I think that stands out as indispensable—critical thinking.

Critical thinking is a cognitive process that involves analyzing, evaluating, and synthesizing information to make informed decisions and solve problems. It's a skill that allows an individual to assess information, identify flaws, and make reasoned judgments.

Regardless of what you are working on, approach the gathering of information by questioning the quality, validity and reliability of sources and statements. Consider potential biases, and, ahem—question your own biases too—as well as weighing the merits of conflicting arguments.  

Critical thinking helps you organize your thoughts, consider others’ perspective, and anticipate counterarguments. Going through this process will get you to a place where you’ll feel you can defend your decision.

If critical thinking is a muscle for you that needs developing, here are some tips that will help:

• Ask Questions…But in The Right Way. Ask more questions (but be curious and not judgmental in your approach).

• Challenge Assumptions. Identify your assumptions and question them. 

• Obtain Feedback. Seek the feedback, insights, and opinions of others, especially those with a differing view.

#4—Challenge Your Assumptions.

As compliance officers, challenging your assumptions is a critical skillset for things like conducting investigations or audits. It also comes in handy when advising healthcare leaders as to whether or not their business decisions are compliant (similar to my COO hypothetical above). 

To that end, it’s worth noting that identifying your assumptions, and asking why you believe in them, can help you in navigating the grey. Going through these motions can help you identify if your evidence rooted in fact or opinion, which can help guide you to a place of feeling more secure in your conclusion.

If challenging assumptions is, well, a challenge for you, then here are some tips that can help:

• Maintain awareness. The first step towards challenging an assumption is recognizing when you have made one. Here, you want to start by identifying the thought processes that are leading you to make an assumption.

• Examine the Evidence. When you do identify an assumption, ask why you believe in it? What evidence has led you to this assumption? 

• Seek Out Contradictory Evidence. Actively search for evidence that contradicts your assumption. The takeaway here is don’t get so blinded your own argument that you can’t see the other side.

If you’d like some additional strategies for challenging assumptions, you can consult a companion article I wrote on this topic back in 2023.

Pulling it All Together

Learning how to navigate grey areas is a valuable skill, allowing for flexibility, open-mindedness, and personal growth. It enable us to navigate complex regulations, interpret requirements and resolve intricate problems by assessing information and make reasoned judgments. 

Simply put, it’s a skillset essential for the effectiveness of any compliance officer. 

Navigating ambiguity can be challenging though. By incorporating these strategies, you will evolve to a place of embracing the grey areas with confidence and resilience unlocking your potential for a brighter future. 

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You can quote the regs.

You know the OIG’s priorities.

You’re up to speed on the latest NCD/LCD changes.

But…leadership still isn’t listening.

Why?

Because knowing the rules isn’t enough.

Healthcare leaders make decisions based on risk, relationships, and results. 

That’s exactly why I created this new free 30 training—Why Healthcare Leaders Resist Compliance—And How to Change That.

To learn more, check out the link below…

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Are you struggling to communicate with the leaders in your healthcare organization?

If so, check out my new self-study course and earn CEUs while you’re at it.

---

Did you find this article helpful?

If so, check out my new book.

It contains proven relationship-building strategies to help improve buy-in to your compliance program.

NOTE: Bulk order discounts are now available—contact me at janstine@bluebirdhealthlaw.com for more details.

TAIL

Making a Culture of Compliance Contagious

In the business of healthcare, where ethical integrity and adhering to regulatory requirements are critical to an organization’s success, promoting a culture of compliance is not merely a goal; it's a necessity. That said, implementing compliance policies or appointing an individual to be the compliance officer is not enough. There has to be a commitment throughout all levels of an organization to do the right thing—and do things right.

In other words, a culture that is contagious.

Not too long ago I stumbled across a book by Jonah Berger, Ph.D., entitled "Contagious: Why Things Catch On." Dr. Berger’s book explores the science behind why certain ideas, products, or messages go viral, while others do not. According to Dr. Berger, there are six key psychological drivers for word-of-mouth communication among humans:

1.     Social Currency

2.     Triggers

3.     Emotion

4.     Public

5.     Practical Value

6.     Stories

As compliance officers, we are continually placed in a position to influence the actions of others. For that reason, we play a significant factor in shaping our organizations’ culture of compliance. The question then becomes— How can we make a culture of compliance worthy of word-of-mouth?

Using Dr. Berger’s framework as a roadmap, below are some ideas to get you started.

Social Currency  

This concept relates to the things we talk about that make us look good to others or enhance our social status. Dr. Berger’s theory is that when something makes people feel knowledgeable or "in the know," they are more likely to share it. For example, think about that new “bingworthy” show you came across via a streaming service. You likely went and told others about your experience, right?

That’s social currency.

So how can we create social currency in the context of compliance work?

Here are some suggestions:

• Find a compliant and business-friendly solution for a proposed new venture that’s being advanced by one of your healthcare leaders.

• Identify lost revenue for a department director while investigating a matter or conducting an audit.

• Incorporate feedback from a department leader in a compliance-related decision (e.g., finalizing a new process or policy).

These are just a few examples where the effort you put into your work will result in your leaders looking good—which in turn improves your chances that they will tell others about what you did for them.

Triggers

Triggers are certain cues in the environment that can prompt people to talk about a product or idea. According to Dr. Berger, familiarity and everyday reminders play a significant role in keeping things top-of-mind. For example, if I were to say “Peanut butter and...,” you’re most likely thinking of jelly even though I didn’t have to say it.

 That’s a trigger.

 So how can we create triggers in the context of compliance-work?

 Here are some ideas:

• Get out of your office and walk around your organization so others physically see you.

• Conduct routine rounding (e.g., consistently visit with staff to see how they’re doing, what’s working well, and what’s not working well).

• Make sure compliance hotline posters are not only displayed throughout the organization, but they have your name and photo on them so others identify you as the person to contact.

These are just a few examples of how you can establish triggers that keeps compliance on the minds of your colleagues. It also helps you establish rapport with others in the organization.

Emotion

According to Dr. Berger, stories with strong positive or negative emotional elements are more likely to be passed on because they create a deeper connection with the audience. For example, you’ve likely seen advertisements for pet adoption services. As a pet owner, those ones are tough for me to watch, but they do grab my attention.

 That’s emotion.

 Here are ways to use emotion in compliance:

• Celebrating milestones and achievements (e.g., 100% completion rate for training, a successful audit, or acknowledging a process change that reduced non-compliance rates).

• Using situational examples from a patient’s point-of-view when discussing potential non-compliance.

• Outlining the financial and reputational impact to a department or organization when discussing concerns of non-compliance (e.g., a breach of PHI that leads to patients’ loss of trust).

By taking these approaches, you are embedding an emotional connection to your compliance message. Over time, this results in a message that resonates with your audience, and is not forgotten when they’re confronted with the next problem to solve.

Public

Public refers to the behavior of others that people mimic, especially in public settings. If something is observable and easily seen, it's more likely to be shared. For example, when my 10-year-old sees one of her friends at school with a cell phone, she comes home and makes an argument to my wife and I that we need to buy her a cell phone.

 That’s the “public” drive of something that is contagious.

 Here’s how we can build this kind of behavior in others:

• Emphasize to your organizational leaders that leading by example demonstrates to employees that a culture of compliance is desired. 

• Recognize a leader or employee in a public forum (e.g., a meeting or newsletter) when they have supported the compliance program.

• Send a thank-you note to an employee’s supervisor when the employee supported the compliance program (e.g., they reported a concern that needed to be corrected).

These are just a few examples of taking a public approach to your work—and fostering word-of-mouth about your compliance program.

Practical Value

People share things that help others solve problems or improve their lives. For example, when I was a kid, there was a TV commercial for Super Glue. In this commercial, they would show a gentleman hanging from a steel beam because they had glued his hard-hat to it. Though I wasn’t working in construction, this image did seem useful if I ever found myself in such a situation.

 So how can we create practical value in the context of a culture of compliance?

 Here are some ideas:

• When you are explaining complex compliance-related concepts, show others how the organization needs to comply rather than telling them. Find or create interesting or memorable visuals, and then use them.

• As you are communicating your compliance message, emphasize how meeting the requirements benefits your audience, not you.

• Making sure that compliance resources are easily accessible (e.g., make it easy to find and use).

Stories

According to Dr. Berger, stories make content more relatable, memorable, and shareable. For example, a few years ago, automobile manufacturer Subaru ran an ad campaign featuring owners of their cars and their stories of how they survived accidents. The ads reinforced the message that Subaru builds a safe car, and used customers’ stories to convey that message.

 We also can use stories to generate word-of-mouth within our organizations.

 For example, we can:

• Show examples of when non-compliance affected patient care (in a way that doesn’t violate HIPAA, of course).

• Discuss how a similarly sized organization arrived at a recent settlement when presenting a training.

• Profile employees who are courageous enough to talk about an important compliance matter (in a way that doesn’t reveal the identity of the employee).

Pulling it All Together

Creating a contagious culture of compliance is a continuous journey. It requires dedication, consistent effort, and a genuine commitment to ethical values. When done well, and compliance becomes ingrained in the organization’s DNA, it has tremendous benefits including minimizing risk and enhancing the organization's reputation. It also can help you navigate the compliance program through the politics of healthcare by building stronger relationships with your leaders.

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Do you have a team member struggling to communicate with the leaders in your healthcare organization?

If so, check out my new self-study course and earn CEUs while you’re at it.

---

Did you find this article helpful?

If so, check out my new book.

It contains proven relationship-building strategies to help improve buy-in to your compliance program.

NOTE: Bulk order discounts are now available—contact me at janstine@bluebirdhealthlaw.com for more details.

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Leveraging the Similarities of Your Role to the CFO to Change the Perception of Compliance

In the highly regulated world of healthcare, the Compliance Officer (CO) and the Chief Financial Officer (CFO) play pivotal roles in ensuring the organization operates effectively and within the bounds of the law. 

While I do not advocate for a CO reporting to a CFO, I think there is value in getting your leadership team to see your role like that of a CFO.

Why?

The responsibilities for each area often mirror one another, yet for whatever reason, CFOs tend to be looked at more like a business partner, whereas CO’s are viewed like an obstacle. For example, I’ve never seen a CFO struggle to get a seat at the table, yet I can recall countless times I, and other CO’s have faced this challenge.

So if you can get your leadership team to see your role like that of a CFO, it will help you change the perception of compliance—and effectively navigate the politics of healthcare. This article will cover some of the key parallels between these two roles and how you can leverage them to demonstrate to your leadership team that you are a business partner.

(Note: For purposes of discussion, I’m generically using the term “Compliance Officer” to also includes roles such as a Chief Compliance Officer or Compliance Director depending on organizational nomenclature and how the program is set up.)

Strategic and Advisory Leadership

Both the CO and CFO are strategic leaders who guide their organizations through intricate landscapes. Each role ensures their respective areas align with the organization’s broader mission and objectives. 

More specifically, the CFO ensures financial stability, while the CO ensures adherence to laws and regulations. For example, the CFO must manage budgets, revenue cycles, and investments in a way that sustains clinical operations. Similarly, the CO ensures that billing, patient privacy, and clinical practices comply with regulations such as HIPAA, the Stark Law, and the Anti-Kickback Statute. As a result, both areas support the organization’s mission by protecting it from legal, financial, and reputational risk. Both roles also advise their leaders on how to make the best business decision for the organization.

The Takeaway:

• Pay attention to how your CFO interacts with your operational leaders—and more importantly, how your leaders respond to the CFO. Is there a difference? If so, why? If they’re responding to the CFO more favorably, then connect with your CFO to see if there are some insights you can apply to your own communications.

Mitigating Risk

Mitigating risk is a core function of both roles. The CFO manages financial risks—such as market fluctuations, reimbursement challenges, and operational inefficiencies. Meanwhile, CO oversees compliance risks, including audits, regulatory changes, and internal misconduct.

Inherent to this work, both roles often collaborate to identify and mitigate overlapping risks, such as billing fraud, which can have both compliance and financial repercussions. As a result, their shared goal is to protect the organization from harm, whether it’s a financial loss or a regulatory penalty.

In many cases, the CFO and CO also work together, especially on issues such as audits, internal controls, and fraud prevention. Their joint efforts ensure the organization’s financial health and compliance integrity are upheld.

The Takeaway:

• The old saying—“there is safety in numbers.” If you haven’t already done so, build a strong relationship with your CFO. This can help you effectively collaborate and communicate on projects with your leadership teams to gain their buy-in.

Delivering the Good News—and the Bad

Given the CO and CFO have to manage issues involving organizational risk, both roles have to be adept at delivering good and bad news.

For the CFO, financial statements, budget discussions, and performance metrics all represent areas ripe for potentially good or bad news. For the CO, investigations, audit findings, and regulatory changes similarly have the potential to be positive or negative information depending on the circumstances.

The Takeaway:

• Pay attention to how your CFO interacts with your operational leaders when delivering bad news. Are there any insights you can apply to your own communications that are real and fun, but not real fun? If this is an area you struggle with, then I invite you to check out a separate article I wrote about delivering bad news.

Balancing Proactivity and Reactivity

Both the CO and the CFO must anticipate potential challenges and respond effectively during times of true emergency. For example, the CFO might have to prepare for potential funding cuts, while the CO monitors emerging regulatory changes to preempt non-compliance. The CFO may have to navigate an unexpected loss of significant revenue, while the CO has to guide the organization through a large scale data breach.

Proactivity involves building systems that prevent little issues from becoming big ones. Internal and external audits, compliance training, monitoring, and corrective action are all examples applicable to either role in the organization. Reactivity, on the other hand, demands calm but swift action such as targeted corrective action or overcoming a financial shortfall.

The Takeaway:

• In my experience, CFO’s tend to take a big picture approach and maintaining a calming presence when navigating proactivity and reactivity. These are models that can aid in the approach to your work. If these are areas that you struggle with, you can check out additional articles I wrote on taking a big picture approach and maintaining a calming presence.

Pulling it All Together

The CO and CFO share a common goal: to safeguard a healthcare organization’s ability to deliver high-quality care to the communities it serves. While they operate in distinct domains, their roles often converge in areas such as strategic advisement, risk mitigation, and cross-departmental collaboration. 

Though the responsibilities for each role often mirror one another, CFOs tend to be looked at more like a business partner than a CO. Instead of viewing this a negative, see it as a positive. That is, an opportunity to gain insights that you can use to alter your approach to more effectively communicate with your leadership team. I have found that when my leadership team identified my role to be similar to that of the CFO, I was able to change their perception of compliance—and effectively navigate the politics of healthcare.

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The Course is Now Live!

A step-by-step guide to help you change the perception of compliance from obstacle to business partner.

And the best part?

You can earn CEU credits while you’re at it

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Did you find this article helpful?

If so, check out my new book.

It contains additional communication and relationship-building strategies to help improve buy-in to your compliance program.

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Identifying and Closing Communication Loops

Earlier this year, I wrote about a communication challenge that compliance officers face on a daily basis—determining who to tell and when to tell related to an issue that has surfaced. In this article, I’ll address another challenge that often comes up—that is, when someone hasn’t closed a communication loop.

Ensuring a communication loop is closed—where information flows back to confirm receipt, understanding, and follow-up—is critical for healthcare organizations. That is true whether the matter pertains to patient safety, operational efficiency, or corporate compliance.

Being able to identify when there is a communication loop that needs to be closed, and how to close it, is key to the effectiveness of any compliance officer. It can mean the difference between a little mess becoming a big one. It is also a skillset that can help you in navigating the compliance program through the politics of healthcare.

Failing to Close the Loop

When someone doesn’t follow through and close a communication loop, it’s a variation on figuring out whom to tell and when to tell, but this version occurs on the back end of the issue after it’s been resolved.

What causes these communication gaps? Some examples include the following:

• Isolated Decision-Making: Decision-making confined to specific departments without seeking input or insights from other relevant teams.
  

• Strict Hierarchical Communication: Hierarchical communication structures that inhibit open dialogue between employees at different levels and departments.

• Limited Information Sharing: Employees or departments not sharing crucial details related to an operational process or organizational objective with other teams.

• Communication Barriers: Limited or no communication channels between departments (e.g., no cross-functional meetings or cross-departmental projects).

• Competing Objectives: Departments pursuing individual objectives without considering broader organizational goals.

• Departmental Rivalries: Unhealthy competition or rivalries between departments.

• Inadequate Training Across Departments: Employees lacking training in areas outside their immediate department, limiting their understanding of the organization as a whole.

• Limited Cross-Functional Understanding: Employees having a narrow understanding of their own roles and responsibilities without a broader awareness of how their work contributes to the organization’s overall success.

While the above list is not intended to be all-inclusive, it does represent common scenarios where organizational departments operate in isolation, thereby creating the potential for someone to fail to close a communication loop. 

Strategies for Closing the Loop

So what can you do to minimize communication gaps related to a compliance matter? Below are some strategies that can help:

• Clarify Roles and Responsibilities: When appropriate for your role on a project, clearly define roles and responsibilities within each department to avoid confusion. If it is not within your role, then speak up to identify a need for clarity for the good of the group. 

• Establish Clear Communication Protocols: Set standard protocols for how information is shared, documented, and confirmed. Also, using formats like SBAR (Situation, Background, Assessment, Recommendation) or IRAC (Issue, Rule, Analysis, Conclusion) can also minimize ambiguity and ensure everyone is on the same page.

• Self-Awareness: Be mindful about your own actions to ensure that you’re not engaging in siloed communication. When appropriate and respectful, communicate with others in the organization who have a legitimate need-to-know.

• If You See Something, Say Something: If you are communicating with others, and recognize that someone with a legitimate need-to-know is not included in the discussion, say something. You can either speak up to whomever controls the communication, or close the loop yourself if it’s appropriate to do so.

• Leverage the Speak-Back Method: When giving instructions or updates to another team member or operational leader, have the recipient repeat or paraphrase the information. This speak-back method helps confirm mutual understanding and highlights any areas requiring clarification.

• Encourage Cross-Functional Teams: When addressing a compliance-related matter, create cross-functional teams that include members from different departments so that all affected employees understand the broader picture of the matter.

• Promote Open Communication: When appropriate, be mindful of promoting a culture of openness where employees feel comfortable sharing ideas and information (e.g., establish regular project meetings, feedback sessions, surveys, one-on-one discussions, or open forums).

• Provide Cross-Training Opportunities: Whenever possible, cross-train employees to develop a broader understanding of the different roles involved in a project. This can be particularly helpful when it comes to ensuring the organization is meeting compliance requirements.

• Engage in Communication Self-Assessment: Encourage teams to evaluate their communication. For example, during investigations, audits, or educational roll-outs, assess whether any communication breakdowns contributed to a communication gap. Apply lessons learned to refine processes and training.

In addition the above-noted strategies, developing a communication plan, being aware of your political landscape, and thinking like a healthcare leader can also help you overcome this challenge.

Pulling it All Together

Closing a communication loop is not just a best practice—it’s a necessity for ensuring patient safety, operational efficiency, and corporate compliance. By implementing these strategies, you can strengthen the communication frameworks within your organization. It can also help you improve the effectiveness of your compliance program and navigate it successfully through the politics of healthcare. 

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The course is now live!

A step-by-step guide to help you change the perception of compliance from obstacle to business partner.

If you want to your healthcare leaders to …

✅ Proactively reach out to you with questions or concerns
✅ Champion a compliance program initiative
✅ Spot issues and direct their staff to contact you

Then check out the link below for all details on this new course.

And the best part?

You can earn CEU credits while you’re at it.

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Holiday party coming up?

Not sure what to get your team members?

The gift of knowledge always fits. 😁

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PS-A Kindle version is also available—no shipping required. 😁

How to Get Others to Accept a Difficult Decision

Making difficult decisions is a challenging part of the daily life of a compliance officer—and getting others to accept those decisions—can be even more daunting. Whether you're confronting a high dollar repayment to Medicare or implementing a major organizational change, having a plan for communicating difficult decisions is key to your ability to navigate the politics of healthcare.

Below are five strategies to consider including as part of your communication plan. 

#1–Communicate Transparently

When you're faced with a difficult decision, transparency is key. Clearly explain the reasoning behind the decision (i.e., “the why”), the relevant factors considered, and the potential impacts. 

Transparent communication also means not minimizing the downside. Be honest about the pros and cons, and allow space for questions and concerns. This openness can mitigate feelings of frustration and confusion, helping people to see the bigger picture.

#2–Involve Stakeholders—Early and Often

One of the most effective ways to gain acceptance for a difficult decision is to involve key stakeholders in the decision-making process from the beginning. When people feel they have a voice, they are more likely to support the outcome, even if it’s not their preferred choice. 

Engagement can take on many forms such as conducting surveys, holding meetings, and gathering individual feedback. Regardless of approach, the focus should be on the perspectives of those affected by the decision.

In my experience, inclusion fosters a sense of ownership and collaboration, which greatly improves your chances for buy-in to the difficult decision. 

#3–Highlight the Benefits

While a difficult decision often has clear downsides, it’s important to emphasize the benefits (e.g., reducing organizational liability, cost savings, or improved efficiency). Seek out the silver lining and make sure to articulate the positive outcomes that will result from the decision. For example, you could show how the decision will ultimately benefit patient care, the organization, or the community. 

When people can see the potential advantages, they are more willing to accept short-term discomfort.

#4–Empathize and Acknowledge Emotions

From disappointment to anger, difficult decisions often evoke strong emotions. Acknowledging these feelings—and any sacrifices—shows that you understand the human impact of the decision. Take the time to listen to concerns and validate the emotions of those affected.

In my experience, empathy goes a long way in easing tensions and fostering a supportive environment. When people feel heard and understood, they are more likely to move forward, even if they don’t fully agree with the decision.

#5–Be Prepared to Adapt and Offer Support

Even after a difficult decision is made, the process isn’t necessarily over. Be prepared to adapt if the implementation faces significant operational resistance or unforeseen challenges. Offering support, whether through resources or training, can help ease the transition and reinforce the message that you’re committed to everyone’s success despite the difficult circumstances.

Pulling it All Together

Every compliance officer has to make tough decisions, and those decisions often have consequences that can affect reputations and careers. Gaining acceptance for a difficult decision is rarely easy, but the approaches outlined above will help you work through the process more effectively. Taking this approach will also help you navigate the politics of healthcare more successfully. As you work through a challenging situation, remember that the goal isn’t just to enforce the decision but to bring the organization together to move forward constructively.

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If you liked this article, check out my book. It contains additional interpersonal communication strategies—a great gift for onboarding new team members.

(Note: Bulk order discounts are also available—contact me at janstine@bluebirdhealthlaw.com for more information.)

How to Sell Compliance Without "Selling" Compliance

From conducting investigations to advising leadership to educating staff, as compliance officers, we are continually placed in a position to influence the actions of others. Unfortunately, a reality of our profession is that we are challenged when it comes to the perception of our role in the organization. Before we even have a chance to utter a single word, healthcare leaders often see us as an obstacle—some sort of grown-up version of a hall monitor.

That doesn’t mean the perception can’t be overcome. We just need to work at it—which means focusing on how we are communicating a compliance message of “do this” or “don’t do that”.

If we want to increase engagement to our compliance programs, then we need to interact with our leaders in a way that is selling compliance—without, ya know—“selling” compliance.

So how do you do that?

Below are five strategies that will help.

1-Establish Rapport with Your Leaders

While there are endless ways in which you can establish rapport with a leader, two specific tactics that have helped me include (1) knowing the organization’s market, and (2) taking an active interest in my healthcare leaders.

Knowing the Organization’s Market

Aside from carrying out your compliance officer duties, be intentional about knowing the market in which your organization participates. That means knowing what services your organization provides, who are your business partners, and who your competitors. It also means knowing where your organization sits in the market (i.e., who is better at providing ___ services to patients). To improve your knowledge, study up on your market through general internet searches, talking with your leaders, and paying attention to what they are saying.

Take an Active Interest in Your Leaders

Any time you are interacting with a healthcare leader you have an opportunity to find out as much as you can about them professionally. For example, you could ask questions such as the following:

• “How did you get into this line of work”?

• “What does your day, week, or month look like?”

• “What’s been your biggest accomplishment so far?”

• “What’s been your biggest challenge so far?”

You can also seize these moments to find out as much as you can about them personally. Now, in order to keep the conversation from becoming too personal and super awkward, just ask—

“So, what do you like to do when you’re not working?”

When you take time to understand your organization’s market and take an active interest in your leaders, it positions you to initiate or engage in dialogue about topics unrelated to compliance. Over time, these approaches establish rapport with your leaders which helps you in selling compliance to them.

2-Do Your Homework

Another strategy for selling compliance, (which also helps in establishing rapport), is to do your homework. Since that’s admittedly a super vague statement, let me define it. When I say “do your homework”, I mean learn as much as you can about the role of the leader(s) you’re working with, and the operations-in-question to the issue you are addressing. Below are two tactics that I typically factor into my homework on any issue I’m working on.

Know your Audience

When it comes to knowing your audience, always approach the compliance message with consideration of the audience’s point-of-view (POV). How would [insert your audience] view this particular topic? What questions would they have? If you are not sure of the answers to these questions, then what I typically do is ask the staff —or the leaders over the staff—for feedback and insight.

Also, using relatable examples when communicating a compliance message demonstrates knowing your audience. For example, if I were educating a group of physicians about HIPAA and safeguarding PHI, I might use an example of discussing a patient’s treatment plan in front of friends or family members.

Understand Their Operations

Ensuring that you understand the operations related to the specific issue you are addressing also demonstrates that you did your homework. Here, you want to be thinking about the matter from the perspective of the individuals that are having to live with the regulatory requirements—not the person enforcing them. In order to do that, there are a couple different approaches you can take.

First, you can learn about the department and their processes, by interviewing the leader(s), and staff. Ask very detailed questions about how they perform the work. As you are asking questions, be mindful to make sure it’s coming across as you being curious and not judgmental. An approach I’ve found helpful is to have them explain what they do as if they were explaining it to someone off the street with no healthcare operational experience.

Another approach is to have them lead you on a department walkthrough, or shadow their staff. In my experience, if you really want to understand the work, (and show interest in your leaders), see and experience the work first-hand.  

Taking the time to do your homework sends a message to your leader(s) you are genuinely interested in the work they do and empathetic to the challenges they face. This will leave them felling like you are understanding their point-of-view (POV) and trying to find a solution that will work for them.

3-Anticipate Their Questions

Another approach to selling compliance is to anticipate your leaders’ questions and be prepared with the answers. Below are a couple tactics that have helped me. 

Think Like a Healthcare Leader—Not a Compliance Officer

Recalling back to my POV comments above, you have to momentarily climb into the mind of your leader by looking at the matter from their perspective—not yours. If you were the leader over this department, what questions would you have about the regulatory requirements? Are there specific terms within the regulation that I would want to understand? What do certain words and phrases mean as applied to my operations? What challenges do I face in trying to meet these requirements? What organizational pressures am I currently facing (e.g., budgetary constraints, staffing, resources, meeting performance goals). These are some of the questions you need to be thinking about in order to think like your leaders.

Know How Decisions are Made in the Organization

Another tactic is knowing how decisions are made in the organization. For example, let’s say there was an audit that identified a billing error which resulted in a six-figure repayment to Medicare. If you are going into a discussion with your CEO to explain what happened and the path forward for resolution, be mindful that a CEO will want to make sure the CFO is aware. That means before you meet with CEO, either invite the CFO to participate in the discussion or, alternatively, let the CEO know you have already vetted the matter with the CFO.

Similar to the other strategies discussed, taking this approach is another way to demonstrate that you are taking into account your leaders’ POV, which helps you in selling compliance to them.

4-Focus On How Your Work Benefits Them—Not You

Another approach for selling compliance is to keep your message focused on how your work supports their department or the organization as a whole and not the compliance program.

For example, let’s assume you are conducting an investigation into a breach allegation reported from a patient. Here, you want to communicate the need to ensure the organization appropriately handles the investigation and response so that trust is restored with the patient. Also, you want to focus on highlighting your concerns that the organization does not suffer financial or reputational harm should the patient choose to report the matter to the Office for Civil Rights.

Anytime you can keep the focus of your message on how it benefits your audience, it will significantly improve your chances of ensuring the message is relatable. Over time, this will improve your ability to sell compliance to your leaders.

5-When You Bring a Problem, Bring a Solution

Finally, if you want to improve your engagement to a culture of compliance then be intentional to communicate the identified issue—and the proposed solution—as a packaged communication.

For example, let’s assume you have been made aware that the organization inadvertently billed Medicare for a particular procedure in error (e.g., the wrong procedure code was billed).  When you alert the appropriate leader(s) of the news, you want to explain what occurred, how it occurred, and why it occurred. That’s bringing the problem which is step one to the communication.

If you want to sell compliance, then you need to take your message a step further by explaining the solution (e.g., what steps you are taking to resolve the matter).

When you take this approach, you will be reducing their anxiety by communicating a clear path for mitigating risk and restoring the organization back to a state of certainty. Over time, this approach will help you in selling compliance to your leaders.

Pulling it All Together 

With all the different strategies you may have noticed a common theme—focusing on the perspective of your audience instead of you.

While it may seem counterintuitive, (i.e., to get more engagement you have to focus on things other than the compliance program), following these strategies will help you sell compliance and improve your engagement. Over time, these strategies will also help you navigate the compliance program through the politics of healthcare.

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If you liked this article, check out my book. It contains additional interpersonal communication strategies—a great gift for onboarding new team members!

(Note: Bulk order discounts are also available—contact me at janstine@bluebirdhealthlaw.com for more information.)

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Compliance Communications: Determining Who to Tell and When To Tell

I’ve been fortunate enough to have had the opportunity to be a compliance officer for organizations of all shapes and sizes. Some of them had numerous lines of business and over 200,000 employees, while some had a single line of business and only 20 employees.

Though the size of the organizations differed, I found that many the political battles I had to navigate were still the same and based on two underlying themes—miscommunication and misunderstanding. For example, if the people who were supposed to be “in the know” were not included in a discussion, then mis-understandings, hurt feelings, and errors resulted because of the miscommunication.

While there is an endless list of scenarios that can play out for a compliance officer fitting these themes, in this article I want to focus on one—determining who to tell about a compliance matter—and when to tell them. Having this skillset will improve your ability to build stronger relationships with others, gain buy-in to the compliance program, and effectively navigate the politics of healthcare.

Determining Who to Tell and When to Tell

Almost on a daily basis, compliance officers are confronted with two questions in their minds as they approach their work (“Who do I need to tell?” and “When do I need to tell them?”).

For some issues, those questions will be pretty straightforward to answer. For others, it may be a bit more complicated. For example, if an issue involves processes covering more than one department, it may require figuring out which healthcare leaders to include. Additionally, depending on the level of compliance risk involved, you may also need to first communicate to your supervisor and any leaders over the impacted departments. From there, involve others on a need-to-know basis.

Another complication that often comes up with these scenarios is the fact that you may not be in a position of having all the facts at the time you first become aware of the issue. The question then becomes this:

Do you say something now or wait until you have more information?

If you’re not sure how to proceed, your first thought should be to have a conversation with your most trusted resource— your supervisor. I have found that going through the motion of speaking out loud with a supervisor about your thought processes can help determine the most appropriate communication plan. Having this conversation will also help you understand what is expected of you with future communications.

Develop a “No Surprises Act” Communication Plan

Another angle to this communication challenge is not surprising your operational leaders, or your supervisor. For that reason, and with a nod to a recent US Federal healthcare law surrounding price transparency)—it’s best to set up what I like to think of as a “No Surprises Act” communication plan.

I’ve mentioned in other articles that healthcare leaders do not like to be surprised. That is true whether one of their direct reports is notifying them of a budgeting or clinical care mistake, or if you as the compliance officer, are notifying them of something like an overpayment.

When it comes to communicating about compliance issues, you want to avoid dropping a surprise on your leaders as much as possible. For example, if you sense there may be a delay in finding out an answer to resolve an issue, it’s best to proactively communicate with others identified as “need to know.”

During this initial communication, you’ll cover the fact that the issue surfaced and what steps you are taking to resolve it. From there, continue to communicate with this group until the issue is resolved. The same policy should be applied when communicating with your supervisor. Taking this approach will help you maintain a strong business relationship with both audiences.

While such a communication plan sounds like a no-brainer, the reality is that certain parts of your job will force you to strategically think through when to communicate with others in the organization. For example, if you are working on an investigation that has political implications (e.g., investigating one of your senior leaders), you may need to find a sweet spot between not alarming others unnecessarily and avoiding a surprise. To help navigate this challenge, I offer a quick tip:

Put yourself in the shoes of your audience.

Ask yourself, “If I were in this person’s role, when would I want to know this information?” Going through that process can help in you determining who to tell about what you are working on, and when to tell them.

Pulling it All Together

When it comes to overcoming this political battle, there are a couple of universal thoughts to keep in mind. First, whenever you are working on a compliance matter, develop a communication plan. Identify who you want to communicate with and when you plan to communicate with them. Second, always be aware of the political landscape around you. Often the landscape will help guide your communication plan. Finally, remember to think like a healthcare leader when communicating with them. This will help you in determining, from your audience’s perspective, when they would like to be looped into certain communications.

Having the ability to know who to communicate with, and when to communicate with them, will help you in maintaining the trust of your supervisor and other healthcare leaders. Over time, these strategies will improve your ability to build stronger relationships with others—and more effectively navigate the compliance program through the politics of healthcare.

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If you liked this article, check out my book. It contains additional interpersonal communication strategies—a great gift for onboarding new team members to your organization.

Overcoming Siloed Communication

In today’s fast-paced business environment, effective communication is critical to an organization’s success. As it relates to the complex regulatory landscape of healthcare, effective communication also plays a pivotal role in ensuring that the organization remains compliant. Compliance officers, tasked with maintaining adherence to these regulations, often face significant challenges when communication within the organization is siloed. 

A few months ago I wrote an article entitled, Overcoming Communication Blindspots, where I briefly touched upon siloed communications as one example of a blindspot. This article will extend that discussion by offering some strategies to help overcome siloed communications. Having this skillset improves your ability to gain buy-in to your compliance program—and help you effectively navigate the compliance program through the politics of healthcare.

What is siloed communication?

For purposes of this article, I define “siloed communication” as a situation where an employee, or a department, is not communicating with others in the organization who have a legitimate need-to-know. Sometimes these situations are the intentional, while other times they are not. To help illustrate what these situations look like, consider the following examples of siloed communication:

• Isolated Decision-Making: Decision-making confined to specific departments without seeking input or insights from other relevant teams.

• Strict Hierarchical Communication: Hierarchical communication structures that inhibit open dialogue between employees at different levels and departments.

• Limited Information Sharing: Employees or departments not sharing crucial details related to an operational process or organizational objective with other teams.

• Communication Barriers: Limited or no communication channels between departments (e.g., no cross-functional meetings or cross-departmental projects).

• Competing Objectives: Departments pursuing individual objectives without considering broader organizational goals.

• Departmental Rivalries: Unhealthy competition or rivalries between departments.

• Inadequate Training Across Departments: Employees lacking training in areas outside their immediate department, limiting their understanding of the organization as a whole.

• Limited Cross-Functional Understanding: Employees having a narrow understanding of their own roles and responsibilities without a broader awareness of how their work contributes to the organization’s overall success.

While the above list is not intended to be all-inclusive, it does represent common scenarios where organizational departments operate in isolation, thereby hindering collaboration and overall efficiency.

Depending upon the circumstance, siloed communications can spill over into a compliance issue. For example, let’s assume there is a new Medicare billing requirement affecting a clinical department (e.g., medical imaging). If the medical imaging department was never made aware of the new requirement and continues to treat and bill for services provided to patients under the old requirement, the organization is now looking at an investigation and potential repayment. For that reason, it’s helpful for compliance officers to have some strategies for overcoming siloed communications in order to foster a more efficient—and compliant, organization. 

Strategies for Overcoming Siloed Communication

Below are some strategies that can help you when it comes to siloed communications:

• Self-Awareness: Be mindful about your own actions to ensure that you’re not engaging in siloed communication. When it is appropriate, and respectful, communicate with others in the organization who have a legitimate need-to-know.

• If You See Something, Say Something. If you are communicating with others, and recognize that someone with a legitimate need-to-know is not included in the discussion, say something. You can either speak up to whomever controls the communication, or close the loop yourself if it’s appropriate to do so.

• Encourage Cross-Functional Teams: When addressing a compliance-related matter, create cross-functional teams that include members from different departments so that all affected employees understand the broader picture of the organization.

• Promote Open Communication: When appropriate, be mindful of promoting a culture of openness where employees feel comfortable sharing ideas and information (e.g., establish regular project meetings, feedback sessions, surveys, one-on-one discussions, or open forums).

• Provide Cross-Training Opportunities: Whenever possible, cross-train employees to develop a broader understanding of different roles within the organization. This can be particularly helpful when it comes to ensuring the organization is meeting compliance requirements.

• Clarify Roles and Responsibilities: When appropriate for your role on a project, clearly define roles and responsibilities within each department to avoid confusion. If it is not within your role, then speak up to identify that need for the good of the group that is working on the project.

Pulling it All Together

Siloed communication is often a significant factor producing misunderstanding and conflict in an organization. At times, these situations can spill over into a compliance issue that needs to be addressed.

By implementing the above-noted strategies, you can help break down silos and create a more collaborative and compliant environment. Over time, developing this skillset will improve your ability to gain buy-in to the compliance program—and effectively navigate the politics of healthcare.

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If you liked this article, check out my book. It contains additional interpersonal communication strategies—a great gift for onboarding new team members to your organization.

Five Strategies for Handling Tough Feedback

Receiving tough feedback can be challenging, but let’s face it—it’s an essential part of personal and professional growth. In my opinion, that’s really true whether you work in compliance, or any other profession.

Yes, there are times when someone could say something in a kinder way, but as the recipient of the message, we have also a responsibility in how we respond. Learning how to accept critical feedback with grace and resilience can make all the difference in your development journey—and improve your ability to gain buy-in to your compliance program.

In this article, I’ll explore some common places where tough feedback intersects with compliance work, and provide some strategies to help you in overcoming this challenge.

Tough Feedback and Compliance

Call it criticism, or as a close friend of mine used to say—“a self-esteem workshop”—tough feedback is receiving a less-than-positive message about something you’re working on, or how you’re working on it.

In the compliance officer role, we often have to be the bearer of bad news with our healthcare leaders. To that end, tough feedback can take on many different forms. For example, it could be pushback from a department leader about how a regulatory change impacts their operations. It could be a disagreement about your response to a proposed business deal or the results of an audit. And tough feedback can be tied to how you are communicating your compliance message surrounding all these activities.

Knowing how to accept critical feedback can be a key factor between engagement and avoidance with your compliance program. For that reason, let’s take a look at some strategies that will help.

Strategies for Handling Tough Feedback

When it comes to handling tough feedback, you need to have the ability to focus on the content of the message instead of the messenger, or the way the message is being conveyed.

If that sounds easier said than done, then consider the following five strategies:

#1-Separate Emotion from Fact

It's easy to let emotions cloud your judgment when receiving tough feedback. When it comes to any situation, there are facts—and then there are interpretations of facts. The trick becomes identifying which one you are basing your response on.

To handle tough feedback effectively, you need to separate the emotion behind the feedback from the actual facts. To do that, keep your state of mind grounded in curiosity and not judgment. This will allow you to evaluate the feedback more objectively.

#2-Seek Clarification from a Curiosity State of Mind—Not a Judgmental One

Piggybacking off of the first strategy, if the feedback you’re receiving is unclear or ambiguous, then don't hesitate to ask for clarification—but do so from a state of mind rooted in curiosity and not judgment.

Keep in mind that when you’re receiving information, your state of mind will be felt by others. For example, if you’re bogged down in judgment, it will come across negatively as being defensive. On the other hand, if your state of mind is based on curiosity, it come across positively as being focused on how to improve.

To maintain your focus on curiosity, seek specific examples or instances where you may have fallen short. Also, even with the toughest feedback, there is often a grain of truth that you can learn from. Search for that instead of focusing on the negativity.

Taking these approaches not only helps you understand the feedback better but also demonstrates your willingness to learn and improve.

#3-Embrace a Growth Mindset

Building off of the last strategy, adopting a growth mindset is also crucial when handling tough feedback. Instead of viewing it as a criticism of your abilities, see it as an opportunity to learn and grow.

To that end, don’t be afraid to reach out for support from colleagues, mentors, or friends during challenging times. Discussing the feedback with others can also provide valuable insights and perspective to help you grow professionally.

#4-Keep Your Focus on Solutions—Not the Problem

Rather than dwelling on the problem that is the subject of the feedback, shift your focus to finding solutions. Here, you want to brainstorm actionable steps you can take to address the feedback and make meaningful changes.

By taking this approach, you not only develop your critical thinking skills, but also build confidence by independently developing potential solutions.

#5-Reflect and Process

Finally, take time out to reflect on the feedback once your initial emotions have settled. Here, it’s very important to climb outside of your head and identify “the why” behind the feedback that was given and how you can use it to become better.

For some practical steps, you can set aside this time for personal reflection, try journaling, or discussing the feedback with a trusted mentor or friend. These can all be strategies to help you process the feedback more positively and effectively.

Lastly, a disclaimer.

Despite my joking above, receiving tough feedback can be hard on ones’ self-esteem, so practice self-compassion by reminding yourself that nobody is perfect, and everyone makes mistakes. If you are passionate about your work, others will easily see that, and you’ll have the capital to lighten up on yourself when you make a mistake.

Tough Feedback and The Politics of Healthcare

Having the ability to handle tough feedback is a critical asset to help you in navigating the politics of healthcare. For example, when you are able to accept negative feedback and maintain a calming presence while doing so, you will position yourself as having a sense of professional judgment that can be trusted. Over time, this helps you build trust and develop stronger relationships with others in the organization.

Also, when you can focus on acting on the message being delivered and not evaluating how it’s being delivered, you become better equipped to think creatively to find solutions that work under any scenario.

Finally, being skilled at handling though feedback, aids your ability to resolve conflict by taking into account the point-of-view—and emotions—of other interested parties.

Pulling it All Together

Let’s be honest, handling tough feedback is never easy, and quickly challenges your ability to remain professional. With the right mindset and approach though, it can be a powerful asset for your growth and development.

Having this skillset will keep you from losing  your cool—and the trust of your healthcare leaders. Over time, these strategies will improve your ability to build stronger relationships with others in the organization and more effectively navigate the compliance program through the politics of healthcare.

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If you liked this article, check out my book. It contains additional interpersonal communication strategies—a great gift for onboarding new team members to your organization.

If You Want Buy-in to Your Compliance Program—Avoid "Gotcha Moments”

As compliance officers, we are continually placed in a position to influence the actions of others and shape our organization’s culture of compliance. Unfortunately, with a title like “compliance officer,” we have an image issue to overcome which makes our job that much harder. Before we even have a chance to say a word, healthcare leaders often see us a grown-up version of a hall monitor.

One way to change this perception is to avoid creating what I like to call “gotcha moments”.

In this article, I’ll define gotcha moments and take a look at how they can negatively affect your ability to influence the actions of others. I’ll also provide some strategies to help you in changing the perception of compliance so that you can successfully navigate your compliance program through the politics of healthcare.

What are Gotcha Moments?

For purposes of this discussion, a gotcha moment means trying expose or embarrass someone for doing something wrong. For example, let’s assume my six year old tells me he brushed his teeth this morning. If I surreptitiously go into his bathroom to see if his tooth brush is wet, and then confront him about it because it’s dry—that’s a gotcha moment.

In the context of the corporate world, let me give you another example. Assume a fellow employee sneaks around to find the answer to a question and then asks someone on the team the question to see if he or she knows the answer, or potentially catch a co-worker in a lie—that’s also a gotcha moment.

Compliance and The Gotcha Moment

So, what does a gotcha moment look like relative to compliance work?

Let’s imagine someone in the compliance department is conducting an audit involving the review of medical-necessity documentation to substantiate billing Medicare for physical therapy services. For funsies, let’s call this person“Schmidlap”.

Let’s assume Schmidlap holds an entrance conference with the department director, (“Laurie”), to explain the purpose and scope of the audit. After the meeting, Schmidlap goes off to review the documentation against the regulatory requirements, but never asks Laurie about how the department provides and documents the service for billing purposes. At the end of the audit, Schmidlap holds an exit conference with Laurie, and her supervisor, where he reveals that all the claims audited in his sample were missing documentation to support medical necessity. As a result, Schmidlap tells the Laurie that the organization now has to refund several thousand dollars in overpayments and implement a corrective action plan.

Since Schmidlap waited until the end of the audit to reveal the issues he was finding, it’s going to feel like a gotcha moment to Laurie. Relatedly, she is going to feel like the purpose of the audit was to embarrass her in front of her supervisor.

The problem with engaging in such behavior, as a compliance professional is that our job title alone sends a message that the very goal of our position is to do this. For that reason, being mindful of gotcha moments and avoiding them whenever possible, will go a long way to obtaining buy-in to your compliance program.

The Political Fallout from “Gotcha Moments”

The biggest downside to gotcha moments is that they signal deception. This contradicts, and can render moot, any efforts you’ve made to establish the compliance program as something to be trusted.

In that audit example above, if Schmidlap didn’t talk to Laurie about what he was finding and then delivered shocking news to her…at best,Laurie is going to feel blindsided. At worst, she is going to feel disrespected as a human being.

Gotcha moments can also cause others to question your credibility or professionalism. In the audit example, what if Schmidlap was wrong in his conclusion that the documentation didn’t exist? What if the documentation ended up living in another part of the medical record that Schmidlap wasn’t aware of, because he didn’t take the time to talk with Laurie. Such a situation would potentially raise concerns about the quality of Schmidlap’s work product and whether it can be trusted.

Strategies to Avoid “Gotcha Moments”

So, how can you avoid creating gotcha moments in compliance work? Here are four strategies that will help.

#1-Subscribe to a “No Surprises Act” Communication Plan

Whether you are consulting to employees on a matter related to the organization’s business or compliance agenda, conducting an audit, or anything in between—communicate with them. Have an open dialogue with those you encounter to make sure you understand the facts.

Also, if you identify a potential issue, bring it up promptly and be transparent. If there is one thing I’ve learned in my career, it’s that healthcare leaders do not like to be surprised. That’s true whether one of their direct reports is notifying them of a budgeting or clinical care mistake, or if you as the compliance officer are notifying them of a high-risk issue.

#2-Have a Strategy for Delivering Bad News

Unfortunately, sometimes, it’s our job to be the messenger of bad news. When faced with this situation, have a plan for how you will deliver the news that addresses two central questions:

1.     How will I mentally prepare the leader to hear this news?

2.     What is my proposed solution to resolve the issue and prevent a future occurrence?

Since bad news has the potential to shock, the first question will help you figure out how the news will land with your audience. The second question is intended to help you see the issue from your audience’s perspective and reduce their anxiety.

#3-Assume Neutral Intent When Consulting to Your Healthcare Leaders

When you are consulting to healthcare leaders, assume neutral intent until your facts prove otherwise. Neutral intent means that we don’t know whether a person acted with good or bad intent. When you assume neutral intent, you avoid inappropriately judging others or jumping to conclusions. (Note: Your communications also will be received with more respect.)

#4-Establish a Default Mindset of Curiosity—Not Judgment

If you are working on an audit, or advising about whether or not certain conduct is compliant, question people from a place of curiosity and not judgment. Given your role, others will assume that you are attempting to judge them. You can avoid that perception by proactively disclaiming that your intent in asking questions is merely to understand the facts.

Pulling it All Together

As a compliance officers, we work hard to foster a healthy culture of compliance and positively influence the actions of others. We also want our colleagues to have a psychologically safe place to report issues and concerns. That said, gotcha moments undermine this work and cause employees to lose trust in the compliance department.

By following the above-noted strategies, you will be more self-aware of potential gotcha moments and put yourself in a position to avoid them whenever possible. When you take this approach, it will not only improve buy-in to your compliance program, but help you successfully navigate the compliance program through the politics of healthcare.

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If you liked this article, check out my new book. It contains additional interpersonal communication strategies—great for onboarding new team members to your organization!

How to Avoid Creating a False Sense of Urgency

In the fast-paced environment of today’s highly regulated healthcare industry, urgency often appears in compliance work as a driving force behind productivity and success. Not all matters are urgent though, and creating a false sense of urgency can backfire in the form of heightened stress, burnout, and ineffective decision-making. 

Given that our audience generally assumes urgency based on our job titles alone, it is critical to be able to distinguish between genuine urgency—and a manufactured one.

In this article, I’ll explore circumstances that create a false sense of urgency and provide some strategies for overcoming this challenge. Having this skillset can keep you from losing the trust of your healthcare leaders and improve your ability to navigate the compliance program through the politics of healthcare.

A False Sense of Urgency

So what is a false sense of urgency? It’s self-explanatory, but to illustrate what it looks like in the field, consider the following situational examples…

• The Overuse of “Urgent” Communications. The practice of labeling every task as urgent, even the ones that aren’t true emergencies.

• Setting Arbitrary Deadlines. This conduct involves setting deadlines for others without a clear rationale or consideration for the actual time needed to complete the task.

• Micromanagement. The practice of demanding immediate updates or engaging in continual oversight on tasks that don’t warrant such attention.

• Procrastination. Waiting until the last minute to address important tasks.

• Perceived Competition. Believing that success hinges on outpacing others in a race to achieve what is an internally-imposed goal.

While not an all-inclusive list, they do have a common theme—they all represent manufactured emergencies.

A False Sense of Urgency and The Politics of Healthcare

The problem with creating a false sense of urgency is that it negatively affects your ability to navigate the compliance program through the politics of healthcare. For example, let’s look at overuse of urgent communications. This approach is similar to the story in Aesop’s fable—The Boy Who Cried Wolf. If you’re labeling every task as urgent, it dilutes the significance of your true emergencies. The end result is that your audience will tune you out at a time when you need it most.

Also, if your audience is receiving emails consistently marked as urgent, but the matters are trivial in nature, you may experience difficulty in building strong relationships. That is because the overuse of urgent communications creates unnecessary stress felt by others. It also causes them to question if your professional judgement is one that can be trusted.

Strategies to Avoid Creating a False Sense of Urgency

So what can you do to reduce your chances of creating a false sense of urgency? Below are six strategies that can help.

• Prioritize Tasks Objectively. Take the time to prioritize tasks based on their true importance and deadlines. Avoid inflating the urgency of every task so as not to dilute the significance of genuinely time-sensitive matters. Ask yourself is this deadline important to serving your needs, or that of the organization?

• Evaluate Your Consequences. Before labeling a task as urgent, consider the actual consequences of delayed completion. Is your deadline related to a government audit, or revising an internal document? Not every task carries equal weight and recognizing that will help you prioritize effectively.

• Set Realistic Deadlines. Establish deadlines that are reasonable given competing demands for time. This will allow for adequate time to complete tasks effectively.

• Impose Buffer Zone Deadlines. Add in a buffer zone to your project timelines. For example, if your actual deadline is June 30th, seek to have it completed by June 15th. This will help you account for unexpected delays or revisions that are needed to your work.

• Communicate Clearly. Articulating clearly about the expectations for timelines, deliverables, and the rationale behind urgent requests can help avoid misunderstandings about urgency.

• Judiciously Label Communications as Urgent. Reserve the "urgent" label for situations that genuinely require immediate attention and pose heightened risk to the organization.

(Note: For some additional strategies, consider checking out two companion articles I wrote last year: How to Maintain a Calming Presence when Responding to Compliance Issues and How to Take a Big Picture Approach to Compliance Work.)

Pulling it All Together

Distinguishing between genuine urgency and manufactured pressure is essential for maintaining productivity, and fostering a healthy culture of compliance throughout the organization. In the long-run, having this skillset can also help you effectively navigate the politics of healthcare.

Keep in mind that in order to avoid creating a false sense of urgency, you’ll need healthy dose of self-awareness about how you are interacting with others. By following the above-noted strategies though, you will not only improve your self-awareness, but also experience an increase in buy-in to your compliance program.

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Also, check out my new book.

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Overcoming Communication Blind Spots

Effective communication is a cornerstone of successful interactions, whether it’s personal relationships or in a professional setting. That said, even the most well-intentioned communicators can fall victim to blind spots that hinder mutual understanding and connection.

As it relates to resolving a compliance matter, knowing how to interact with others in the organization can be the difference between getting push-back and obtaining buy-in. For that reason, being able to recognize and address these blind spots can be helpful for fostering clearer, more meaningful communication.

In this article, I’ll identify a few common communication blindspots and provide some helpful tips to improve your ability to navigate the politics of healthcare.

Communication Blind Spots

While not an all-inclusive list, below are four common communication blindspots that tend to exist in healthcare organizations. Getting a handle on each of these can help you avoid misunderstandings and potential conflict.

The Hierarchical Barrier

With any healthcare organization, there is some type of organizational structure consisting of employees, supervisors, managers, directors, senior leaders, and a governing board. With all these different layers, it is very easy for information to get filtered or distorted as it moves up or down the organizational hierarchy.

While there is a legitimate need for controlling certain information within the organization so as not to jeopardize the ability to make effective business decisions, there can be a downside. Gaps in understanding get created and details or feedback from some levels in the organization may not reach the decision-makers accurately.

Here are some tips that can help you navigate this blind spot:

• Be mindful of need-to-know communication. If you’ve identified another individual or department that has a legitimate need-to-know, then ask if they have been made aware of the information, or if appropriate, take steps to close the knowledge gap.

• When appropriate, encourage open communication channels with those who have a legitimate need-to-know.

• Empathize with those who are not in-the-know. Ask yourself, “If I was in this person’s shoes, would I want to know this information?” Then be judicious about taking action. If you own the communication and it’s appropriate to be transparent, then proceed in letting the other person know. If you do not own the communication, then determine if it is appropriate to voice your concerns to your supervisor, or whomever owns the communication.

The Assumption Trap

“The Assumption Trap” occurs when one assumes that others in the organization share the same knowledge or perspective as the communicator. The risk here is that if the audience does not share the same knowledge or perspective, it leads to misunderstandings, which often leads to conflict.

Here are some tips that may help overcome this blindspot:

• Actively listen, ask clarifying questions, and speak back information to ensure all parties understand the facts.

• Challenge your assumptions and the assumptions of others. 

• Make sure that conclusions are based on facts and not personal opinions. 

(Note: For more information on challenging assumptions, check out this companion article.)

The Siloed Communication

Ahhhh, the dreaded silo. You’re likely familiar with this little gem, but if not, this communication blindspot happens when departments or individuals fail to appropriately communicate with others (thus operating in isolation like a silo).

“The Siloed Communication” often leads to a lack of coordination and shared understanding about a particular matter. As a consequence, projects suffer from misalignment and healthcare leaders get surprised with unexpected information. For example, if an internal auditor conducts an audit and identifies payer refunds, but neglects to notify the CFO about the refunds—that’s siloed communication.

When it comes to the politics of healthcare, the problem with siloed communication is that it leads to frustration and creates the potential for conflict. Additionally, in the context of my internal audit example, taking such an approach signals deception—which renders moot—any efforts to establish the compliance program as something to be trusted.

If siloed communications is something you’d prefer to avoid, here are some tips that can help:

• Promote collaboration and open communication during meetings and calls by identifying all interested parties that need to be aware of the content of a communication.

• Follow the tips I mentioned above for “The Assumption Trap” to avoid presuming that an individual is aware of a communication.

• As appropriate, validate with the communicator that an individual with a legitimate need-to-know is made aware of the content of a communication.

The Unclear Expectation

Finally, we come to “The Unclear Expectation”. Here, the concern with this blindspot is that lack of clarity leads others to not understand their roles, which leads to confusion or inefficient productivity. This can be especially true when the communication is coming from the compliance department and it relates to getting others to follow a regulation or internal policy.

Keep in mind that when you are communicating with a healthcare leader about a compliance issue, these folks likely will not be as knowledgeable about the rules as you are—so there is a knowledge gap. Be mindful of that potential and close the gap if you’ve identified one exists.

You also want to make sure you are clear about the compliance expectation. Here, my recommendation would be to ask yourself honestly, “Am I clear about what I’m expecting of others?” If you’re struggling with answering that question, then chances are you’ve either not critically thought through the matter, or there are some questions that still need to be answered.

(Note: A separate discussion on the importance of critical thinking skills in compliance can be found here.)

So how can you overcome this communication blind spot?

Here are some tips that may help:

• Strive for clarity in your communication by avoiding jargon, ensuring conclusions are based on facts, and mapping out the communication from beginning to end in an outline.

• Before you communicate with a healthcare leader about a compliance expectation, make sure you can answer this question from their perspective—”So what do you need from me?”

• If someone else owns the communication and has not clearly communicated an expectation, speak up and let them know. (You can use the question mentioned in the bullet point directly above.)

Pulling it All Together

Communication blind spots play a significant role in the politics of healthcare. For example, workplace conflict often exists because of a lack of information or false assumptions based on limited information. Additionally, engaging in siloed communications, or ones involving “gotcha” moments, can damage your relationships with healthcare leaders and contradict your efforts to build a strong culture of compliance.

For those reasons, it is important to be mindful of communication blindspots and address them whenever possible through the above-noted tips. These can help avoid conflict, or at a minimum, prevent a little mess from turning into a big one.

If there is one piece of parting advice I can offer it is this—when it comes to communication blindspots, follow your own recommendation to employees for reporting a concern—if you see something, say something. 

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Take Your Work Seriously, But Don't Take Yourself Too Seriously

Without question, compliance work is serious business. The work we do is important to patient care. It is important to the organizations we work for. And it is important to tax-payer-funded healthcare programs. Simply put, the work requires that it be taken seriously. But that does not mean a compliance officer needs to be a serious person...well... not all the time, at least.

If you want to effectively navigate the politics of healthcare, take your work seriously, but don’t take yourself too seriously. Now, you may be thinking, “Hey, man. I like a good joke as much as the next person. Are you saying I need to be a comedian?” Not exactly, but let’s break this down a little more.

Take Your Work Seriously

Taking your work seriously means you are passionate about your work. That is true, no matter what line of work you are in—accounting, painting, medicine, plumbing, etc.

In the compliance officer profession, there isn’t a more accurate indicator of taking your work seriously than passion. Whether it’s reviewing regulations or conducting an audit, the work is tedious and labor intensive. As I covered in a separate article a couple weeks ago, you have to unconditionally love the struggle of compliance work—and that takes a special person to voluntarily endure that kind of pain.

Don’t Take Yourself Too Seriously

So what do I mean by “Don’t take yourself too seriously”? A few thoughts come to mind.

First, it means not beating yourself up when you make a mistake. When you are passionate and thorough in the approach to your work, you have the capital to lighten up on yourself. You’re human, and all humans make mistakes. As it relates to how you externally process mistakes, of course, you need to take that seriously. That is your work. Genuinely apologize and follow through on your steps to correct so that trust is not lost.

As it relates to how you internally process the mistake, this is where some people vary in how they respond. You need to be able to laugh at yourself. People who take themselves too seriously become too afraid to fail, and when they do fail, it becomes too much for them to accept. People who are self-confident because they worked hard have no problem admitting their mistakes. They may even bounce back by throwing in a little self-deprecating humor. When you can laugh at yourself in front of others, you are not taking yourself too seriously.

Not taking yourself too seriously also means you have a healthy dose of humility. Now, humility can mean different things, but for me, humility looks like a person who is grateful for what they have. It looks like listening to others and enabling them to be heard. And it looks like asking for help when you need it. These are traits that one should possess, no matter one’s socioeconomic background. Let me give you an interesting example of humility that I experienced in my life.

In 1997, I was working as a bartender in Sun Valley, Idaho. Yes, it is true. I was “finding myself ” after college. It was a time that my father had really hoped wouldn’t last long.

If you’re not familiar with Sun Valley, think Beverly Hills but in the mountains. It’s filled with celebrities and the uber-wealthy either living or vacationing there. Every day was an out-of-body experience that resulted in me calling my folks to tell them whom I saw. It’s a ridiculous fantasyland. A perfect place for someone finding themselves.

One night I was working at an annual event put on by a major investment company out of New York. It was a who’s who of multimillionaires and multibillionaires. While I was serving drinks before dinner, a gentleman tapped me on the shoulder. He asked me if he could have a glass of wine sitting on the tray I was holding. As I turned around, my twenty-two-year-old male brain mumbled, “Yeah” to this person—but he didn’t quite hear me. He said, “Oh. No, I can’t have it?” in an almost apologetic tone. As I fully turned around to give him the glass of wine, I immediately recognized who it was. It was Bill Gates.

At the time, he was the second wealthiest person in the world, with a net worth of $36 billion. Though I politely replied, “Oh, yes, you can have it,” I will tell you inside I was actually thinking, “Holy crap!!! You’re Bill Gates! I believe you can have this free glass of house wine!”

I mention this story because I have never forgotten how impressed I was with how he carried himself. It was as if he were no better than I was, though Forbes would certainly feel otherwise. Humility is about understanding that we’re all equally valuable, and that is demonstrating that you are not taking yourself too seriously.

Pulling it All Together

The takeaway here is that if you want to be effective at navigating the politics of healthcare, take your work seriously but don’t take yourself too seriously. This approach can help you in building relationships and communicating with others. Since some healthcare leaders perceive us to be about as impersonal as a computer, this approach can help change the perception of compliance. It adds a human element to your work.

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An Unconditional Love for the Struggle of Compliance

I will be the first one to admit that compliance-related work is not for everyone. You really have to have a love for this type of work, which means an unconditional love for the struggle that goes along with the work.

Personally, I think this true in life, no matter what you seek to do.

In this article we’ll take a look at an unconditional love for the struggle of compliance work and how it affects your ability to navigate the politics of healthcare.

An Unconditional Love for the Struggle

As some can attest, I absolutely love to ski. If you were to ask my wife, she would say that I probably love it more than life itself. It’s my happy place. It’s where I feel like a kid again, out on an adventure. It’s where I feel the most alive.

Inherent to that love, though, is an unconditional love for the struggle that goes along with skiing. Skiing means being outside in the cold, so you have to be OK with that. Being outside in the cold also means you’re going to have a runny nose. Are you OK with that? And skiing means shoving your feet into ski boots. Now as much as I love to ski, I will be the first to admit that ski boots are not exactly comfortable. They’re also an awkward pain in the a** to walk around in.

These are all examples of the struggles that go along with skiing. These are also things I don’t think about because I don’t think of them as struggles. I appreciate them for what they represent to me: the opportunity to ski.

For me, compliance work is very similar.

A Love for the Struggle of Compliance Work

Deep down, you have to have an unconditional love for struggle that is part of the job, or you’ll never make it. If you can happily sift through endless pages of a final rule published in the Federal Register, you have an unconditional love for the struggle of compliance work. That means you can see past the fact that the content is dry and the font is mind-numbingly minuscule.

If a new investigation is exciting to you because it seems like an interesting adventure, you have an unconditional love for the struggle of compliance work. That means the tedious steps needed to document your work doesn’t bother you.

If resolving a complex issue seems like an opportunity to learn and grow, then you have an unconditional love for the struggle of compliance work. That means you’re at peace with the amount of time and work it will take to resolve the matter.

If these are examples that resonate with you, then I’d say you have an unconditional love for the struggle of compliance work.

Navigating the Politics of Healthcare

So how does an unconditional love for the struggle of compliance work relate to navigating the politics of healthcare?

If you have such a love, then it’s a sign you are passionate about your work. When you are passionate about your work, others in the organization will see it come out in your interactions with them. (Even if they don’t understand or agree with it.)

They will see you as a trusted resource when it comes to advising them on compliance-related matters, and that gives you capital. The kindof capital that positions you to establish rapport with your leaders and build strong relationships with them as you work through a question or issue. Over time, your ability to find solutions during times of conflict will improve, as well as increase your chances of gaining buy-in to your compliance program.

Pulling it All Together

An unconditional love for the struggle of compliance work is an excellent benchmark as to whether the career choice you have made is a good fit for you long term. It also is an asset that can help you in navigating your compliance program through the politics of healthcare.

In my experience, an unconditional love for the struggle is something that must occur naturally. It can’t be forced. With that said, figuring out whether you have an unconditional love for the struggle of compliance work can only be identified over time. So how do you know?

The litmus test I’ve used professionally is money. If there were no such things as money and bills to pay, would you still perform this job? Put another way, if you won the lottery tomorrow, would you still want to do this work?

Going through this exercise will always provide you with your answer.

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The Importance of Executive Presence in Compliance

As healthcare compliance officers, we are tasked with ensuring that our organizations adhere to a complex web of laws and regulations tied to patient care and reimbursement. An often overlooked— but vital asset to the effectiveness of your compliance program—is the ability to demonstrate executive presence. In this article, we’ll take a look some of key characteristics that define this important skillset, and how executive presence can help you in navigating the politics of healthcare.

What is Executive Presence?

Executive presence is a combination of qualities, both tangible and intangible, that convey leadership, credibility, and confidence. It’s more than physically how present yourself in a corporate setting, it encompasses how you communicate with others and inspire them to act—compliantly, of course.

Individuals with a strong executive presence can be characterized by the following traits:

• Effective Communication—They speak clearly, concisely, and with conviction, as well as actively engage in meaningful conversations.

•  Authentic—Their personality is genuine in nature, whether they are on stage or off-stage.

• Emotionally Intelligent—They navigate complex interpersonal situations effectively because they can identify the emotions of others and know how to manage their own.

• Confident—The believe in their abilities and commit to them.

• Handle Stress Gracefully—They maintain their composure in high-pressure situations.

• Decisive—They make timely decisions and take responsibility for them regardless of outcome.

• Big Picture Thinker—They have the ability to see the end of a project before starting on it by considering various options and potential outcomes.

For a compliance officer, these traits can make a significant difference in how you resolve an issue and build credibility as a trusted business partner to those in operations.

Executive Presence Tips

If you seek to achieve the above-noted traits, here are five tips to help you improve your ability to demonstrate executive presence as you interact with others in the organization.  

1. Mentally prep for your discussions ahead of time. (Think about what information you need to convey to your audience, anticipate questions you may get asked, and what actions you need them to take.)

2. Develop and refine your critical thinking skills. (For tips on critical thinking, click here.)

3. Build confidence by identifying weaknesses and practicing the skills needed to overcome them.

4. Focus on maintain a calming presence as you address and resolve a compliance issue. (For strategies on maintaining a calming presence, click here.)

5. Improve your emotional intelligence by developing tools for emotional self-awareness, self-care, and empathy.  

Executive Presence and The Politics of Healthcare 

Executive presence is a critical asset to help you in navigating the politics of healthcare. For example, when you are able to confidently communicate with others and maintain a calming presence while resolving an issue, you will position yourself as a credible resource. Over time, this helps you build trust and develop stronger relationships with those in operations.

Executive presence also helps you positively influence the behavior of others in the organization. When you critically think through a compliance matter by challenging your assumptions, considering various outcomes, and factoring in the feedback of others, you are better equipped to find solutions that work. Finally, executive presence aids your ability to resolve conflict by taking into account the point-of-view—and emotions—of other interested parties.

When factored together, this skillset improves how you interact with others in the organization and your ability to obtain buy-in to the compliance program.

Pulling it All Together

Executive presence skills are a must for any compliance officer. They help you communicate more effectively and project confidence as you resolve an issue. They also improve your chances of building credibility as a trusted business partner to those in operations. In the context of navigating the politics of healthcare, executive presence helps you to build stronger relationships with others in the organization, as well as positively influence behavior, and resolve conflict. In order to be effective, executive presence should be authentic to you. These traits aren’t about being someone you're not—rather becoming the best version of yourself.

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