The Circle of Influence for Doctors Planning Retirement or Portfolio Careers

Every time doctors bring the clinical perspective into a strategic meeting, they are working in the Circle of Influence.

In healthcare, we often talk about authority and we are familiar with hierarchy. Consultants, medical directors, professional bodies and national government all sit neatly in our mental map of “who’s in charge”. If you are planning retirement or building a portfolio career, these experiences can translate into your next chapter. While job titles, organisational charts, formal responsibilities are important, the real work of change happens through something less obvious, more subtle and more pervasive: the power of influence.

In a previous post, I wrote about Covey’s Circle of Concern, which reminds us to focus our energies on things we can control and let go of things we cannot. What happens in the transformative space between the two?

This is the Circle of Influence, and it's the place where a lot of advocacy work takes place. According to the Cambridge Dictionary, advocacy is the act of supporting, speaking up for, or representing a person, group, or cause. It can involve protecting rights, influencing policy and making voices heard. I’m not talking about legal advocacy, where a lawyer represents a client, or individual advocacy such as in safeguarding. I’m talking about systemic or group advocacy, working to change laws, policies, systems and practices for the benefit of patients, systems, communities and societies.

Healthcare professionals care deeply about big policy issues such as national funding decisions, regulatory frameworks and workforce crises. However, we can only directly control these policies if we are given authority to do so and for most of us, for most of the time, they sit in the Circle of Concern. But that does not mean we are powerless. Instead, we can exercise power by building relationships, collaborating with others, gathering evidence and creating narratives that frame problems and inspire solutions. This belongs in the Circle of Influence and it is here that advocacy comes alive.

According to Daniel Goleman, the psychologist famous for his work on emotional intelligence, influence is the ability to have a positive impact on others, to persuade or convince them to gain their support. Senior doctors are uniquely positioned to step into advocacy. After decades of clinical experience, you bring credibility, deep insight into systems of care, and an understanding of the human stories behind policy decisions (Gabel, 2012). You’ve seen both the strengths and the shortcomings of healthcare up close, which means you can speak with a powerful blend of authority and empathy. Yet clinicians often underestimate the extent of their influence.

Advocacy offers a way for senior doctors to keep contributing in their encore career, not just by treating individual patients, but by shaping the wider structures that allow others to deliver better care. Policy is shaped by data, narratives and “on the ground” realities that we choose to share (or not share). Every time we contribute to a conversation, brief a leader, present outcomes of a programme or bring a marginalised clinical perspective into a strategic meeting, we are working in our Circle of Influence. If clinicians disengage from committees and networks, they leave their Circle of Influence, their policy influence shrinks, a few voices dominate, skewing the distribution of money and resources.

When we choose to connect with others in our Circle of Influence we can transform the narrative. The knowledge and expertise held within these networks creates collective legitimacy, influence and shared resources. This is social capital, defined as the “innate ability, capacity, and potential of individuals to engage in collaborative, positive interactions and collective efforts” (Institute for Social Capital). This is why, when you direct energy into your Circle of Influence, it expands over time and pushes into the Circle of Concern.

If you want to make the changes that your years of experience tell you the world needs, ask yourself these questions;

• What sits in my Circle of Concern that I need to stop ruminating about and start translating into specific asks?

• Where is my current Circle of Influence? Which boards, networks, working groups or fora do I belong to? How can I use those spaces more intentionally?

• Who is missing from the table, and how can I use my influence to bring their voices into policymaking conversations?

For healthcare professionals, advocacy extends our Circle of Influence into the policy realm. The question becomes: how are we using the influence we already have in our organisations, networks and collaborations to quietly and persistently bend policy towards better care?

If you are a senior doctor contemplating your next career move and getting into advocacy appeals to you, check out my coaching services, including my podcast What the Gen X Doctor Did Next.