CPOM Module 9, Section 3: Overcoming Resistance and Driving Adoption
MODULE 9: CHANGE MANAGEMENT & CONFLICT RESOLUTION

Section 9.3: Overcoming Resistance and Driving Adoption

A practical guide to the psychology of resistance. You will learn to diagnose the root causes of resistance—from fear of the unknown to loss of status—and apply targeted strategies to convert resistors into champions.

SECTION 9.3

Overcoming Resistance and Driving Adoption

From Diagnosis to Treatment: A Clinical Approach to the Human Side of Change.

9.3.1 The “Why”: Resistance is Not the Enemy—It’s a Symptom

In the clinical world, when a patient develops a fever, your first instinct is not to simply administer an antipyretic to suppress the symptom. Your primary goal is to diagnose the underlying cause—is it a bacterial infection, a viral syndrome, an inflammatory response? The fever itself is not the disease; it is a critical diagnostic signal that the body is fighting something. To treat the fever without understanding its source is to ignore the real problem.

Resistance to change in an organization must be viewed in exactly the same way. The eye-rolling in a meeting, the missed deadlines on a project task, the “we’ve always done it this way” comments, the hallway whispers—these are not the problem. They are symptoms. They are the organizational equivalent of a fever, signaling that there is an underlying issue that must be diagnosed. The amateur manager treats resistance as an obstacle to be crushed, a sign of insubordination to be disciplined. The CPOM, operating as a clinician-leader, treats resistance as valuable diagnostic data. It is a natural, predictable, and often logical response to the disruption that change creates.

The “Why” of this section is to fundamentally shift your perspective. Resistance is not a sign that your team is lazy, stubborn, or disloyal. It is often a sign that you, as the leader, have failed to adequately address their legitimate concerns. It may signal a flaw in your communication plan, a lack of perceived support, a genuine fear of job loss, or a past history of failed changes that has bred deep cynicism. By learning to diagnose the root causes of resistance, you can move from a futile, morale-destroying battle against the symptom to a productive, targeted treatment of the underlying cause. This section provides the diagnostic tools and therapeutic interventions to help you do just that. Your goal is not to eliminate resistance—an impossible task—but to understand it, channel its energy, and transform your most ardent resistors into your most committed champions.

Retail Pharmacist Analogy: Patient “Non-Adherence” as Resistance

A patient with newly diagnosed hypertension, Mr. Jones, returns to your pharmacy for his first refill of lisinopril one week late. A quick check of his profile reveals he has only taken about 70% of his prescribed doses. He is “non-adherent.”

The Amateur’s Approach (“Crushing the Symptom”): You lecture Mr. Jones. “Sir, it’s very important you take this medication every day. High blood pressure is the silent killer. You must be compliant with your doctor’s orders.” You have addressed the symptom (non-adherence) but have done nothing to understand the cause. Mr. Jones will likely nod, take the medication, and continue his behavior.

The Clinician’s Approach (“Diagnosing the Resistance”): You approach Mr. Jones with empathy and curiosity. “Hi Mr. Jones, I see we’re a little late on this refill. Sometimes it can be tricky getting into a new routine with a medication. Can you tell me a bit about how it’s been going for you?” You open the door for diagnosis. Through gentle, non-judgmental questioning, you uncover the root cause of his “resistance”:

  • The Diagnosis: Mr. Jones reveals, “Well, I’ve been feeling a bit dizzy in the mornings after I take it, and I developed this annoying dry cough. I didn’t want to bother the doctor, so I just started skipping doses on the days I felt off.”
  • The Root Causes: His resistance isn’t stubbornness. It is rooted in Fear (of the side effects) and a Lack of Knowledge (he didn’t know these were common, manageable side effects or that he should report them).
  • The Treatment Plan:
    • Address the Fear: “The dizziness is very common when you first start. It often gets better as your body adjusts. Let’s talk about getting up slowly in the morning.”
    • Address the Knowledge Gap: “That cough is also a well-known side effect of this specific medication. It’s not dangerous, but it can be very annoying. We can definitely do something about that.”
    • Enable Action & Provide a Solution: “I’m going to call your doctor right now. I’ll explain the cough and recommend we switch you to an ARB, like losartan, which works similarly but doesn’t cause a cough. Would that be okay with you?”

    • You have just transformed a “non-compliant patient” into an engaged partner in his own care. You did this by treating his resistance not as a character flaw, but as a diagnostic clue. Managing resistance in your pharmacy team requires the exact same process of empathetic investigation, root cause analysis, and targeted intervention.

9.3.2 A Clinical Framework for Diagnosing Resistance

Resistance to change rarely manifests as a straightforward “I refuse.” It is often more subtle, appearing as passive aggression, malicious compliance, or a sudden drop in engagement. To effectively counter it, you must first learn to recognize its different forms and diagnose its source. People resist change for logical, rational, and emotional reasons that are very real to them. Your job is to understand their perspective.

We can group the most common root causes of resistance into two major categories: Resistance to the Change Itself (what is happening) and Resistance to the Change Process (how it is happening).

Part 1: Resistance to the Change Itself (The “What”)

This type of resistance is focused on the content of the change. It stems from how the individual perceives the new future state will personally impact them.

Masterclass Table: Diagnosing Resistance to the “What”
Root Cause Underlying Fear or Belief Symptomatic Phrases & Behaviors You’ll Hear/See CPOM’s Diagnostic Questions
Loss of Control / Autonomy “I used to have a say in how I did my job. Now I’m just being told what to do. I feel like a cog in a machine.” “This is just another top-down mandate.”
“Why weren’t we consulted about this?”
Behavior: Rigidly adhering to the old way of doing things.		 “What parts of this new process do you feel you have the least control over?”
“If you could design one part of this new workflow, what would you change?”
Fear of the Unknown / Uncertainty “I don’t know what this means for me. I’m anxious about the future. The devil you know is better than the devil you don’t.” “What’s going to happen next?”
“Is this going to mean layoffs?”
Behavior: Rumor-mongering; repeatedly asking the same questions.		 “What is the biggest unanswered question you have about this change?”
“What is your biggest concern about what our department will look like in six months?”
Loss of Competence “I was an expert at the old system. Now I’m going to look stupid. I’m afraid I won’t be able to learn this new skill.” “I’m just not good with new technology.”
“The old way was much faster for me.”
Behavior: Avoiding training sessions; deferring to others on new tasks.		 “What specific part of the new process feels the most intimidating to you?”
“What resources or training would help you feel more confident?”
Increased Workload / Effort Tax “This is just more work on top of my already busy schedule. The learning curve is steep and will slow me down.” “I don’t have time for this.”
“When are we supposed to get our real work done?”
Behavior: Missing deadlines for change-related tasks; complaining about being overwhelmed.		 “Can you walk me through how this new process impacts your daily workload?”
“What can we temporarily take off your plate to make time for this transition?”
Disruption of Routines & Relationships “I liked my routine. I liked working with my team. This change messes all of that up.” “It was so much easier when I just worked with Sarah on this.”
“I’m still not used to the new shift schedule.”
Behavior: Seeking out old teammates; lamenting the “good old days.”		 “What was the best part about the old way of working that you feel we’ve lost?”
“How can we build some of that positive team dynamic into the new structure?”

Part 2: Resistance to the Change Process (The “How”)

Sometimes, employees may actually agree with the change in principle, but they resist because of how it was planned, announced, or implemented. This is often a direct result of a flawed change leadership strategy.

Masterclass Table: Diagnosing Resistance to the “How”
Root Cause Underlying Belief Symptomatic Phrases & Behaviors You’ll Hear/See CPOM’s Diagnostic Questions
Mistrust of Leadership “They don’t know what they’re doing.”
“They don’t understand what it’s like on the front lines.”
“They aren’t being honest about the real reason for this change.”		 “Here we go again, another ‘flavor of the month’ idea from management.”
“I’ll believe it when I see it.”
Behavior: Deep cynicism; questioning the motives behind the change.		 “What could we, as a leadership team, do to earn your trust on this project?”
“What information do you feel is missing or not being shared openly?”
History of Failed Changes “We tried something like this five years ago and it was a disaster. Why will this time be any different? This is just a waste of time and will be abandoned in six months.” “Remember the ‘Phoenix Project’? This feels just like that.”
“We’re just going to go back to the old way eventually.”
Behavior: Passive participation; a “this too shall pass” attitude.		 “You’re right, the rollout of that last project was handled poorly. What were the biggest lessons we should learn from that experience to make sure we don’t repeat those mistakes?”
Lack of Communication & Input “We were completely blindsided by this. If they had asked us, we could have told them this wouldn’t work. Nobody listens to us.” “This is the first I’m hearing of this.”
“It seems like the decision was already made.”
Behavior: Anger and frustration; feeling disrespected and devalued.		 (This requires acknowledgment, not a question) “You are absolutely right. The initial communication on this was not handled well, and I apologize for that. Let’s reset. I want to hear your perspective and your concerns now.”

9.3.3 The Pharmacist’s Playbook for Managing Resistance

Once you have a working diagnosis of the root cause of resistance, you can prescribe a targeted intervention. Using a single strategy for all types of resistance is like using a single antibiotic for all types of infections—it’s lazy medicine and bound to fail. Your approach must be tailored to your diagnosis. The following strategies represent your core therapeutic options.

The Proactive vs. Reactive Approach

The most effective way to manage resistance is proactively. By anticipating these common causes during the planning phase of your change, you can design your communication and rollout strategy to pre-emptively address them. The strategies below can be used both proactively (to prevent resistance) and reactively (to manage it once it appears).

Strategy 1: Education & Communication

Best For Diagnoses: Fear of the Unknown; Mistrust of Leadership.

This is the foundational strategy. Resistance often arises from simple misinformation or a lack of information. By providing clear, honest, and consistent communication, you can fill the vacuum that breeds anxiety and rumors. This is your primary tool for building Awareness in the ADKAR model.

Masterclass Table: Executing the Education & Communication Strategy
Key Tactic CPOM in Action
Create a “Single Source of Truth” Establish a SharePoint site or shared folder with the project charter, timeline, FAQs, and training materials. Direct everyone to this location for the latest, most accurate information. This combats rumor-mongering.
Hold Open Forums & “Ask Me Anything” Sessions Schedule regular, informal meetings with the project leaders where no question is off-limits. Be prepared to answer tough questions about job security, timelines, and the reasons behind the change. This builds trust and transparency.
Communicate the “Why” Relentlessly Start every meeting and every email related to the change with a brief reminder of the vision and the “burning platform.” Connect the daily tasks of the change back to the high-level goals. Don’t assume that because you said it once, everyone remembers.

Strategy 2: Participation & Involvement

Best For Diagnoses: Loss of Control/Autonomy; Lack of Communication & Input; Mistrust of Leadership.

This is one of the most powerful strategies for converting resistors into champions. When people feel they are part of the process, they gain a sense of ownership over the outcome. Resistance plummets when the change is no longer something being done *to* them, but something being done *by* them. This strategy is key to building Desire.

Masterclass Table: Executing the Participation & Involvement Strategy
Key Tactic CPOM in Action
Involve Resistors in Problem-Solving Identify a vocal critic who has valid points about the flaws in the proposed change. Invite them to lead a small workgroup tasked with solving that specific problem. You give them a voice and make them responsible for finding a solution.
Use Pilot Programs & User Acceptance Testing (UAT) Before a full rollout, create a pilot group of frontline staff to test the new process or technology. Give them the power to provide direct feedback that leads to real modifications. This shows you value their expertise and are willing to adapt.
Co-create the Implementation Plan After the vision is set, involve the team in designing the “how.” Ask them: “What is the best way to train everyone? What is a realistic timeline? What support will you need from leadership to make this work?” This fosters a sense of shared responsibility.

Strategy 3: Facilitation & Support

Best For Diagnoses: Loss of Competence; Increased Workload; Fear of the Unknown.

This strategy acknowledges the emotional and practical difficulties of change. It’s about providing both the psychological safety and the tangible resources people need to navigate the transition. It demonstrates that you, as a leader, understand that change is hard and that you are there to help. This is how you build Knowledge and Ability.

Masterclass Table: Executing the Facilitation & Support Strategy
Key Tactic CPOM in Action
Invest Heavily in Training Provide multiple training formats (classroom, one-on-one, self-paced) to accommodate different learning styles. Crucially, training must be hands-on and conducted in a safe, “no stupid questions” environment.
Provide Emotional Support & Active Listening Hold one-on-one check-ins with your team members. Start the meeting by asking, “How are you doing with this change?” Then, listen more than you talk. Sometimes, people just need to vent their frustrations to a leader who is willing to listen empathetically.
Adjust Workloads and Provide Resources Be realistic about the “effort tax” of change. Temporarily reassign tasks, approve overtime, or bring in temporary help to create the bandwidth needed for training and learning. Ensure the team has the necessary equipment, tools, and access to do their new jobs.
Advanced Strategies: Negotiation and Coercion

There are two additional strategies that should be used sparingly and with great caution, typically only when dealing with powerful stakeholders who are actively blocking a critical change.

  • Negotiation & Agreement: This involves offering incentives or making concessions to a key resistor in exchange for their support. For example, you might offer a department head who is resisting a new inventory system priority access to capital for a different project they want in exchange for their public endorsement. This can be effective but can also be seen as a bribe if not handled carefully.
  • Explicit & Implicit Coercion: This is the last resort. It involves using formal authority to force acceptance through direct or indirect threats (e.g., “This is a required condition of employment,” negative performance reviews, undesirable assignments). While sometimes necessary for critical safety or regulatory changes, this approach will damage trust, create resentment, and should be avoided whenever possible. It addresses the behavior but creates a deep-seated negative attitude toward you and the change.

9.3.4 From Resistance to Adoption: Riding the Adoption Curve

Managing resistance is about mitigating the negative forces. Driving adoption is about cultivating the positive ones. Not everyone will react to change in the same way or at the same pace. The technology adoption lifecycle, a sociological model originally developed by Everett Rogers, provides a powerful framework for understanding how change spreads through a group. By understanding these different adoption profiles, you can tailor your engagement strategy to build momentum and create a “tipping point” where the change becomes an unstoppable force.

The model segments the population into five groups based on their predisposition to adopt new ideas and technologies.

Innovators (2.5%)

The visionaries, the tech enthusiasts. They love change for its own sake. They will be on board before you even announce the project.

Early Adopters (13.5%)

The respected opinion leaders. They are not just interested in the “new,” but in the “better.” They want to see how the change can solve real problems.

Early Majority (34%)

The pragmatic ones. They are not leaders, but they are not laggards. They will adopt once they see proven success from the Early Adopters. They represent the “tipping point.”

Late Majority (34%)

The skeptics. They are risk-averse and will only adopt after the change has become the established standard, often due to peer pressure.

Laggards (16%)

The traditionalists. They are highly resistant and may never fully adopt the change. Their focus is on the past.

The Strategic Mistake: Focusing on the Laggards

The most common leadership mistake is to spend a disproportionate amount of time and energy trying to convince the Laggards and the most resistant members of the Late Majority. This is a losing battle. Your strategic goal is not to achieve 100% enthusiastic adoption on Day 1. Your strategic goal is to win over the Early Majority. The key to doing this is to empower your Innovators and, most importantly, to partner with and support your Early Adopters. The Early Adopters are the key that unlocks the rest of the organization.

Masterclass Table: Driving Adoption Across the Curve
Adopter Group How to Identify Them Strategic Engagement Plan
Innovators They are the ones who send you articles about new technology. They volunteer for every beta test. They are constantly tinkering with processes. Engage them first. Bring them into the planning process early. Let them play with the new technology or process before anyone else. Use their enthusiasm to create initial buzz, but be aware they may not be the most influential group.
Early Adopters These are not necessarily your managers. They are the highly respected, pragmatic clinicians and technicians that others go to for advice. They are credible and trusted. This is your Guiding Coalition. Invest the majority of your early energy here. Give them a central role in the pilot program. Ask for their honest feedback and act on it. Turn them into your “super users” and trainers. Their endorsement is social proof for everyone else.
Early Majority These are the bulk of your competent, reliable team members. They are watching the Early Adopters closely. They want to see proof that the change works and is worth the effort. Show, don’t just tell. Provide them with case studies and testimonials from the Early Adopters. Create clear, easy-to-follow training and support systems. Remove barriers to make adoption as painless as possible. Your goal is to make it easier for them to adopt than to resist.
Late Majority They will ask “Who else is using this?” They are motivated by peer pressure and a desire not to be left behind. They will join when it becomes clear the change is permanent. Provide social proof and clear expectations. Share data that shows the majority of the team has already adopted the new way. Update official policies and performance metrics. Make it clear that the new process is now the standard.
Laggards They will be the last to change, if at all. They will often be vocal about their preference for the “good old days.” Minimize your direct effort here. Do not get drawn into lengthy debates. Provide the same training and support you provide to everyone else, and hold them to the same performance standards. Focus your energy on supporting and celebrating the rest of the team. The social pressure from the group will be more effective than anything you can say directly.