“Rehearse it in your own head to polish your delivery, especially if you’re getting time with a very high-level administrative executive, where your time is going to be limited and your delivery is probably going to be judged, whether you like it or not,” he said. “You can’t come in and be tangential and all over the place with how you present your argument. It has to be linear and logical.”


In addition, keep in mind that whoever you’re making your pitch to likely needs to present your idea to other key decision-makers.


“Knowing what the people who greenlight your projects care about will go a long way to making sure those projects do get approved,” LoBello Reynolds said. “That will help you craft your follow-up email, proposal or memo just a little bit differently because you’ll know how they’ll present it when they slide it across the desk to someone else.”


Getting buy-in from other physicians, especially in other specialties, can also be helpful. “The more you can work collaboratively, the better it is,” Dr. Kothary said. “You’d be amazed how sometimes working with, for example, vascular surgery to request a device that you want means both of you will get that device. Use your colleagues as another way to boost your ask.”


These alliances will also help you present a better narrative and demonstrate more opportunities for the hospital to grow and increase revenues.


“The more you can show those concentric circles out from your project and how everyone can clip into its success, the easier it is to craft the story around why it makes sense,” LoBello Reynolds said. “Let’s say it is an innovative new technology that’s going to be very different for your area. The more people who can say, ‘We were a part of that process,’ and claim it as a win for themselves as well, the more likely you are to get the ‘yes’ that you’re looking for.”


Behaviors to avoid While developing communication, presentation and negotiation skills takes time—and often only gets better with practice—there are some hard-and-fast rules of what not to do.


Dr. Katzen has witnessed plenty of examples of colleagues not making progress in talks with hospital administrators. Sometimes they don’t make the patient or business case, but instead align it with their personal goals. Other times their approach is not planned out in a methodical way.


One of the more serious mistakes is to take a “no” personally and lose your cool. “Temper tantrums are always a bad idea,” Dr. Kothary said.


Physician–administrator relationships can sometimes be seen as adversarial, Dr. Desai said. Physicians may feel like they’re simply receiving edicts from on high, but hanging onto these preconceived notions is not helpful. It’s always important to try to see the administrator’s viewpoint, even if you disagree or the conversation becomes contentious.


“Being adversarial in your tone and your approach is not going to work,” he said. “Being noncordial is not going to work. How you comport yourself is critically important. Being very level-headed when having these


discussions—and being prepared for hearing what you don’t want to hear and processing it—is key.”


Conclusion IRs are change agents, Dr. Katzen said, so they will frequently need to make the case for new procedures, applications and technology. “As interventionalists, we’re always coming with something new to hospital administration,” he said. “So the more thought out, the better.”


While these skills are not usually a part of the medical school curriculum, they are something IRs can develop and improve on over time. “This is a skill set that we were not trained for but is important,” Dr. Desai said. “The move to value-based medicine is here, and this is very much squarely in the art of medicine now.”


Melanie Padgett Powers is a writer/ editor in the Washington, D.C., area. She specializes in health care writing and has also written for the American Optometric Association, American Public Health As- sociation, American Society of Nephrolo- gy and Society of Critical Care Medicine.


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