The Process of Staff Change: Grappling With the Needs of the High-Management Patient

Although there has been no substantiation by any methodologically sound investigation, it is the feeling of the staff, after many months of these meetings, that high-management patients are receiving better care, that the clinic is functioning more as a unit than as a collection of individuals, and that institutional components outside the clinic have been responsive to changes the clinic has made.

What is important here is not so much the outcome but rather the process of change. Having examined their treatment of the high-management patients, the staff understood that the impotency they felt in relation to this patient group was largely self-imposed, and that consequently they had the power to change how they dealt with these patients. Ironically, the systematic self-examination and bona fide self-empowerment these clinicians went through in evolving a treatment approach to the high-management patient are what they would like to see the patients go through themselves. The process has made staff better able to treat high-management patients.