Early-career compliance officers can encounter a common pitfall by preparing thoroughly for what they want to say, but then lose sight of the questions their audience will ask.
(And I say this with a lot of love because I fell into this trap when I started out. Like, a lot.)
When it comes to compliance work, your credibility is not built solely on the content of your message, but rather, on how well you respond to the questions you get asked. In my opinion, anticipating questions is a learned skill that is rooted in understanding how healthcare leaders think and make decisions. When you can identify with those two factors to the extent that it becomes instinct, most of their questions will become predictable.
This article will cover the importance of anticipating leadership questions and give you some tips for how to approach your next compliance conversation.
How Healthcare Leaders Make Decisions
In order to understand the questions you’ll get asked, you first need to understand the decision-making lens of your healthcare leaders. In my experience, most leadership decisions are based on three factors: Risks, Relationships, and Results.
Since that’s an admittedly vague statement, let’s break it down a little further.
When it comes to Risks, keep in mind that to a healthcare leader, this term means more than just regulatory exposure. It means things like: patient safety, weighing the financial stability of the organization, operational efficiency, workforce capacity, strategic growth, competitive positioning in the market, and reputation (whether personal and organizational). To that end, keep in mind that when you bring forward a compliance initiative, they are internally calculating how it affects all of these other domains.
Next up is Relationships. These are equally influential when it comes to decision-making. As I’ve written about in my book, the business side of healthcare functions on informal power (i.e., influence) just as much as formal authority (i.e., the org. chart). Leaders are constantly considering how a proposal will land with others (e.g., the board, physicians, other department leaders, and external business partners). So, keep in mind that a compliance initiative that creates friction with a leader’s relationship, will almost certainly face a struggle to move forward. To that end, you want to position your initiative so that it eliminates, or at least minimizes, this risk. That is, if you want it to succeed.
Finally, Results is the third driver behind a leader’s business decisions. Just like any employee in an organization, healthcare leaders also have performance goals they are trying to meet or exceed. Relatedly, much of what they will advance or push back on, will directly relate to how their results are being impacted. To that end, you want to make sure your initiative aligns with how they can best achieve their goals.
Overall, the takeaway here is that once you begin viewing your compliance work through these three lenses, the questions your leaders will ask you starts to become a little more clear.
Common Leadership Questions You’ll Get Asked
Now that we’ve talked about what drives healthcare leaders to make business decisions, let’s take a look at some of the common types of questions you’ll get asked when discussing a compliance matter. While the exact wording may vary, consider the following categories and questions...
Financial:
What will this cost?
What resources are required?
What financial risk does this prevent?
How does this affect our budget?
Is this the best use of our budget?
Operational:
Who owns this work?
How will this affect our workflow?
Will it slow down patient care?
How long will it take to implement?
Prioritization:
Why are we addressing this now?
How does this compare to other risks we are managing?
What happens if we wait?
Defensibility Questions:
How did this occur?
What steps are being taken to resolve it?
What steps are being taken to prevent a future occurrence?
Has legal counsel been engaged?
What do the regulators expect?
What are other similarly situated organizations doing?
Would this stand up in an external audit or investigation?
Relationship Questions:
Have you engaged the physicians? (or nurses, impacted clinicians, dept. directors, or staff)
Who is going to resist this, and why?
Where do we have support?
While the above list is not intended to be all-inclusive, it does represent some very common questions you’ll get asked. When you prepare for your discussions by keeping these questions in mind—and having answers for them—the flow of the discussion will be more efficient and improve your chances for a positive outcome.
How This Skill Improves Your Effectiveness
Anticipating leadership questions is a skill that demonstrates your effectiveness as a compliance officer. For example, when you build your preparation around the questions your leaders are likely to ask, your presentations become shorter and more relevant (i.e., of value). Also, meetings that may have required multiple follow-ups are resolved in one or two discussions.
Additionally, when you know in advance what questions will be raised, you can engage the right stakeholders before a meeting to discuss the matter. That way by the time you get to the meeting, many of the concerns have already been addressed and you’re better positioned to obtain organizational support.
Finally, anticipating questions helps change your leaders’ perception of compliance from obstacle to business partner. Your healthcare leaders can see, and feel, how you are showing up for the work. Over time, this leads to them proactively seeking you out as a trusted advisor. Why? Because you have demonstrated that you understand their world.
A Practical Method for Getting Started
Ok, so you may be thinking” “this is all great, Jay, but where do I start?”
A simple exercise that you can do is the following:
Identify each person who will be in the room (literally or virtually).
Write down five questions they are likely going to ask you (based on role and priorities).
Answer those questions.
Refine your answers as needed with additional research, or talking with a trusted advisor.
A couple supplemental comments in the form of a “pro tip”:
First, if you are struggling with identifying the questions you’ll get asked, consult a trusted advisor. This could be a close team member, or your supervisor. Going through that process can help identify any questions you may have missed, or any gaps in your response.
Second, you can strengthen this process by talking with operational partners in advance of the discussion and asking what concerns they think will surface? I will tell you this is something I do almost on a daily basis. This can be helpful for not only the discussion-at-hand, but as patterns emerge, you’ll also find yourself accurately predicting questions that will come up.
Pulling It All Together
Early-career compliance officers can mistakenly spend most of their preparation time perfecting what they plan to say instead of how they’ll respond to leadership questions. And when it comes to credibility, fortunately or unfortunately, it’s going to weighed more heavily on the latter.
Anticipating leadership questions is not about being defensive, but rather it’s about translating compliance into the language of organizational decision-making. When you understand that leaders are evaluating every compliance initiative through the lenses of Risk, Relationships, and Results, their questions stop feeling like barriers and start functioning like a roadmap.
When you consistently address leadership concerns before they are raised, you are demonstrating business awareness, strategic thinking, and respect for their operational pressures. And that is what helps move compliance from being perceived as an obstacle to a business partner.
