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Strengthening Negotiation Skills, Part I

How to Use Facets of Knowledge to Create Influence for Public Health Leaders

Fernandez, Claudia S. P. DrPH, MS, RD, LDN; Roberts, Dave BS

Section Editor(s): Baker, Edward L. MD, MPH; Column Editor

Journal of Public Health Management and Practice: March/April 2015 - Volume 21 - Issue 2 - p 214–216
doi: 10.1097/PHH.0000000000000220
The Management Moment

This article focuses on the facets of knowledge that give public health leaders an edge in negotiations.

Department Maternal and Child Health, Gillings School of Global Public Health (Dr Fernandez), and Kenan-Flagler Business School (Mr Roberts), The University of North Carolina at Chapel Hill.

Correspondence: Claudia S. P. Fernandez, DrPH, MS, RD, LDN, Department of Maternal and Child Health, The UNC Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, CB# 7445, Chapel Hill, NC 27599 (

The authors have no conflicts of interest to declare. This work was not specifically supported by any grant or other project.

Leaders face an almost daily need to communicate an engaging vision, to advocate for their programs, and to convince others to align their efforts and support the common objective.1 These skills are essential components of successful negotiation as well. Listed in the leadership competencies set forth from organizations such as the Maternal and Child Health Bureau,2,3 the Association of Schools of Public Health,4 and the National Public Health Leadership Development Network,5 negotiation skills are essential equipment in any leader's toolbox.

Negotiation has been defined as “bargaining (give and take) process between two or more parties (each with its own aims, needs and viewpoints) seeking to discover a common ground and reach an agreement to settle a matter of mutual concern or resolve a conflict,”6 or more simply, “to confer with another so as to arrive at the settlement of some matter.”7 When the outcome matters highly to 1 or more parties at the table, the negotiation process can be much more challenging, which leads to a general impression that negotiation is not typically a pleasant business. Negotiation itself can become far more complex when the negotiation phase mistakenly comes before the influence stage, with the parties negotiating the terms before they have really established the need for a solution. It is the influence stage that is more important and will help public health leaders engage in negotiation successfully because the influence stage first establishes a common goal or vision with the other party. Once there is mutual agreement that a shared need exists, it is far easier to come to terms about the “matter of mutual concern ... or conflict” (the negotiation stage). The frustration with negotiation is understandable and should be expected when the process is engaged from back-to-front rather than front-to-back. Working from the standpoint of first creating influence, there are 5 sources of power to consider: knowledge, attitude, authority, objectivity, and skills. Understanding and addressing these will help make the subsequent negotiations much simpler. This article focuses on the facets of knowledge that will give public health leaders an edge in negotiations. Part II of this article addresses attitude, authority, objectivity, and skills as sources of influence.

As a core component of influence, knowledge can relate to data and information or to insight about a particular subject. Highly trained, technically competent individuals, such as public health or health care leaders, often rely on their fund of knowledge from their technical discipline. For many, it can be tempting to use sheer knowledge (data) to convince others of why they should act or what action they should take—and the more knowledge the better. Inadequate knowledge is addressed by researching the topic. Misjudgments in the value of data occur when the data are interesting, but they do not directly support the issue one is advocating for or are too complex to be easily understood by the other party. While well-targeted data are undeniably important, data do not drive all decision making—nor do they fully drive successful influence or negotiation. For example, the press frequently brings to light stories of people following injudicious courses of action—in the personal, health, business, and even political sectors—or believing in the seemingly impossible for emotional or other reasons. This is also true in public health, as has been sadly demonstrated in the Ebola outbreak in Africa8 and in the cases in the United States, that data and logic may inform, but do not drive, the courses of action for many.

The other major component of knowledge that also requires research is insight data—this includes understanding both the other party and one's self. Insight data can be as rich a fund of knowledge as technical data. Understanding of the other party includes grasping their needs and personal style, as well as one's own assumptions about them. Those who understand their counterparts on the other side of the table are in a far better position to negotiate, in part, because the reduced likelihood of being caught by surprise, becoming flustered, or being distracted by behavior not relevant to the negotiation at hand. Negotiating can be a stressful experience that is made more so by incivility, hostility, or other poor personal behavior from either party. Poor interpersonal skills are costly to organizations9 and unfortunately do occur. When running into these experiences, it is helpful to remember that such displays would be given to any willing or captive audience and are not strictly targeted at the other party in the negotiation. Having the insight of knowing what to expect is part of adequate preparation for a successful experience with negotiating.

Insight knowledge also includes assumptions. Actions are driven by assumptions. Because they all too often impose unnecessary limitations, understanding one's own assumptions can give a public health leader a significant advantage when negotiating. Being blind to one's assumptions can unwittingly serve as an advantage to the other party. As written by author Richard Bach, “Argue for your limitations and sure enough, they're yours.”10(p67) Knowing what one's assumptions are is the first step to being able to move beyond them. Examples of assumptions that might undergird a public health negotiation are “we don't compete in that market” or “those aren't the partners who work with public health” or “we aren't allowed to have revenue-generating functions.”

Insight knowledge also includes thinking like the other party; however, this does not include empathizing with them. While empathy is an asset in some circumstances, it can actually work against successful negotiation. Instead, ask questions such as “How do they see the situation?” or “What are their concerns?” or “What do they need to get out of this situation?” These types of questions help prepare before facing the actual event.

The gaining of knowledge is not limited to the time frame prior to the negotiation. Not all research is completed ahead of time—in fact, in most negotiations, much insight research is done “on the spot” in the context of dialogue. It is here that open-ended questions are invaluable, such as “Why...?” All too often, though, this on-the-spot research into the situation can be stymied by frustrated answers such as “The Director will never go for it” or “We just can't create buy-in to that idea.” When this type of conversation-stopping rebuttal arises, “T.E.D.” questions1,11 are strong tools to use. T.E.D. questions are “Tell me about...,” “Explain to me...,” “Describe for me....” These are tools to help open up greater dialogue, which can provide more knowledge about the situation, the other party, and their needs and concerns.

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The process of negotiation becomes far more streamlined when leaders first engage in the practice of creating influence. Knowledge is a significant source of power and is multifaceted driver of this influence. Embracing the aspects of knowledge that are not simply data based, but rather insight based, can give a public health leader an advantage in the often difficult task of negotiating, making a successful outcome more likely and the experience of the process more pleasant.

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10. Bach R. Illusions: The Adventures of a Reluctant Messiah. New York, NY: Delacorte Press; 1977.
11. Roberts D. Negotiation. Paper presented at: the ACOG National Leadership Institute; April 7, 2013; Chapel Hill, NC.
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