From where I sit – teaching nurses and lactation consultants – questions arise about how to overcome resistance.
Honestly, I don’t think it’s about “Baby-Friendly.” And I don’t think the problem is “physicians;” it’s just people. It’s about change being uncomfortable. Baby-Friendly or not, that’s often the case.
But if you’re finding that the physicians at your hospital aren’t supporting Baby-Friendly with the enthusiasm you’d like, here are few ideas for building support:
Get a physician on the Baby-Friendly committee.
It’s critical to get at least one physician “on board” when building physician support for Baby-Friendly. It’s nearly impossible to move a system forward unless all of the stakeholders are represented. Yet, over and over again, I provide consultation for hospitals that have only a Baby-Friendly committee comprised only of a small number of nurses.
It’s critical to have at least one physician on the committee – one who will champion the cause to other physicians. Better yet, get a doctor-nurse team to co-chair the committee. If a physician is not involved, and if others do not see a physician colleague involved, they are unlikely to value the “new” thing, whether it’s Baby-Friendly or anything else.
Talk about its importance aside from breastfeeding.
Although hospital-based births have medicalized breastfeeding, breastfeeding itself isn’t a medical procedure. Doctors go to medical school. Don’t expect them to be enthusiastic about a non-medical issues. You need to find terms that are important to the doctors when you talk with them about “Baby-Friendly” designation.
For example, talk about Baby-Friendly in terms of its correlations with AAP’s urging for exclusive breastfeeding, complying with directives from the Centers for Disease Control and Prevention (CDC), decreasing morbidity, and reducing mortality. These are terms that are likely to get attention. Saying, “there’s this great new thing for breastfeeding, and we want to protect, promote, and support breastfeeding” is unlikely to resonate with many doctors.
Identify objections to the Baby-Friendly program.
It’s critical to ask about – or better yet, anticipate – any objections. If the doctor feels he will be restricted in his ability to manage a breastfed baby – if he feels that this “program” is Baby-Friendly but physician un-friendly, you’ll need to help him realize he will not be disempowered. Yes, this means you need to initiate some friendly dialogue.
If the physician objects to the mandatory (3 hour) education, find out why. There could be any number of understandable reasons: he doesn’t think he needs to learn anything, he doesn’t want to be taught by a nurse, he doesn’t want to take the time away from his practice, or he’s had so many boring and uninformative continuing education experiences that he dreads sitting through one more.
If you understand what the objection is, you stand a chance of finding a way to address it.
Have the “meeting before the meeting.”
There’s a certain amount of horse-trading that goes on before any meeting – in the hospital, in the community, or elsewhere. Successfully winning a point often depends on a few informal agreements with other colleagues before the meeting begins. Building physician support for Baby-Friendly – or support from anyone, really – is often dependent on these informal meetings.
Yes, sometimes, this is downright hard and shrewd bargaining. If you skip the “meeting before the meeting,” you may find that you’re out on a limb, with no one ready to support you. (And many people waiting with an ax!)
Use persuasion to gain physician support for Baby-Friendly hospitals.
Many resources help us to understand that our approach to an issue makes a critical difference in whether we can influence others to agree. (I especially like Dr. Robert Cialdini’s book, Influence: The Psychology of Persuasion.)
Whether you’re a parent trying to get your kid to eat his vegetables, a pastor trying to convert someone to Christianity, or a lactation consultant trying to convince a doctor to support the hospital’s journey to Baby-Friendly designation, you need to be persuasive! We often assume that lining up the evidence will be enough to convince people – especially healthcare professionals – to see a situation our way. While it’s true that evidence is necessary, it’s seldom sufficient. You need to tap your skills of persuasion as well.
So tell me what you think in the comments below. Have you tried these ideas? Have you tried something else?