1.  
2. Iris Inkwater considers Dr. Fred Fisher to be "old school"': white male, respected physician, early sixties, and in her opinion accustomed to being coddled. Fred Fisher refers to Iris Inkwater as a "young upstart': white female, well-educated mid-forties, and in his opinion overcompensated and not willing to pay her dues.

 

Inkwater thinks of herself as being somewhere between a cooperator and a collaborator. When necessary, she can be contender, though she feels that the costs of battle outweigh the benefits in the long run. In her mind the board of trustees pay her to have the smarts and the guts to use the strategy necessary to get the job done.

Fisher doesn't like touchy-feely conversations, and he doesn't like mucking around with a decision when he knows what needs to be done. He believes a bit of contention makes for creative tension: it keeps people on their toes. It turns the humdrum to work into sport. He finds meetings and group decision making boring. He is paid, and has been around here long enough, to know what needs to be done.

Inkwater has asked Fisher to meet with her. She feels it is important to reframe their working relationship, given the predicament facing the hospital. He is impatient with the discussion before they have even begun talking. In his mind, he can't be part of a solution to a problem he didn't create.

 

Inkwater has walked around her desk and taken a side chair so that she and the head of the medical staff can sit face to face without a piece of furniture between to be certain that you and are working together. And just as important, want them. 'Fred," she begins, "this hospital is facing a real threat to its survival. I want to be certain that people who work here see the two of Us working together."

 

Fisher looks askance. "Are you accusing me of wanting this institution to fail Iris? Because nothing could be farther from the truth. But I am just a simple doctor " "I am saying that Our working relationship could be a lot better, and in fact has to be a lot better if we are going to pull through this.'

"'Look, Iris, you are paid to solve problems and to make sure those problems don't damage our capacity to take care of patients. If you have a problem, or if you have created a problem, don't expect us to solve it for you.'

"That is just what I think we need to correct, Fred. I did not make problem. You read the news. You know all the pressure the health system is under. This problem was not invented by me or even by Community Health Plan. The medical staff cannot simply retreat into its silo and pretend that the rest of the world doesn't exist. We'll get nowhere if we go around blaming one another."

Fisher sits in resigned silence, Inkwater does make sense, and he doesn't know what to do with it. "'What are you suggesting, Iris?" He puts just enough condescension in the way he pronounces her name to make sure she knows who's on top here. Inkwater drops momentarily into the basement and then reminds herself of what she wanted to accomplish with this meeting. She gets back into gear.

Hoping to reframe their working relationship, Inkwater decides on a metaphor that Fisher cannot ignore and perhaps will even understand. "! suggest that we start acting as if we are fellow officers on the same ship. I may be in the engine room, and you may be tending the big guns, but we both depend on the same hull to keep us dry.'

Inkwater senses Fisher's discomfort at being caught off guard. Her metaphor has worked. She is playing his game and succeeding. She also recognizes the need to help him save face. "'Fred, you have more experience than anyone in this institution. The problem is, they are changing the rules of engagement out there.' Seeking to add a touch of humor, she adds, "It's time to get our battle

rhythm."' She looks straight into Fisher's eyes and smiles.

Fisher surprises himself. He smiles back. He begins to appreciate, oddly enough, that he and Iris in fact share a common problem. She is not the "enemy administer" he begins to see her as just the opposite: she has the potential to rescue the ship. If she-no, we-can't come up with a solution, the whole medical center might sink. Her analogy is resonating for him "iris, I am just a simple sailor and I understand you can't sail a battleship alone." He pauses with a sigh. "You're right. I do believe we have to be working together. But it's going to take some adjustment on all our parts." Fisher does not want to retreat from his tried-and-true stance too quickly.

1. How Iris's perceptions of Fred and Fred's perception of Iris might affect their ability to collaborate?
2. Describe the attitudes that might affect Iris's and Fred's ability to find a solution to their disagreements and join together to support their organization?
3. What strategies did Iris use to change how Fred feel about her?
4. Provide Iris three recommendations to help her organization during these challenging times.