Commentary Change Resistors: People Who Block Change Initiatives and 5 Tips to Overcome Resistance Sonja Armbruster, MA; John Moran, PhD, MBA, CMQ/OE, CQIA, CMC; Leslie Beitsch, MD, JD  People don’t resist change. They resist being changed! Peter Senge 1 Any time a change is undertaken in how a public health agency conducts business, resistance is quickly encountered. The authors have worked with a number of state and local health departments and have spe- cific observations about the change process. We offer several concrete strategies to overcome seemingly in- surmountable resistance often faced within the health department. Experienced leaders know that organizational change is a traumatic ordeal for any organization and its employees. An integral part of any change process is resistance, so plans for change should anticipate and manage resistance. It is common that some people in the health department will resist any type of change that impacts them. The more the change is seen as rad- ical and threatening, the more resistance one should expect. The following are the most common resistor archetypes the authors have encountered along the winding road of change within health departments (see the Table). ● Observations Change leader role At the start of any new change intervention, there will always be a mixture of positive and negative opinions, accompanying strong emotions, and groups will form that are aligned with each camp. As a leader you can- not avoid the resistors but you can manage their behav- ior by redirecting their thinking. A change in thinking will result in the desired behavior aligned to the new direction. J Public Health Management Practice, 2013, 19(5), 483–484 Copyright C  2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Avoid change resistors at your peril. Failure to take action will undermine the new change effort. A “change leader” must be a consensus builder by pulling together key stakeholders, individuals, and resistance groups to engage their support in the change initiative. To build this consensus, the change leader must clearly commu- nicate a compelling vision for the health department staff that refocuses direction, habits, and daily work activities. In addition, the change leader must be realis- tic and describe the challenges and consequences that will inevitably arise if the health department does not make the needed change. 2 Five strategies for overcoming resistors 1. Speak to loss. As Heifetz and Linsky 3 assert in their book, Leadership on the Line, Staying Alive Through the Dangers of Leading, “People do not resist change, per se, people resist loss.” (p11) Thus, the change leader must speak directly about loss and engage those with the most to lose, targeting those individuals to work closely with the change leader in the imple- mentation process. 2. Get them on the bus. Jim Collins in Good to Great demonstrates through his research that great companies start by getting the right people on the bus, the wrong people off the bus, and the right people in the right seats. 4 Change can include hir- ing outside talent or helping unproductive team Author Affiliations: Division of Community Health Planning, Sedgwick County Health Department, Wichita, Kansas (Ms Armbruster); Public Health Foundation, Washington, DC (Dr Moran); University of Minnesota School of Public Health (Dr Moran); and Center for Medicine and Public Health, Florida State University College of Medicine, Tallahassee (Dr Beitsch). The authors declare no conflicts of interest. Correspondence: Leslie M. Beitsch, MD, JD, Center for Medicine and Public Health, Florida State University College of Medicine, 1115 W Call St, Tallahassee, FL 32306 (les.beitsch@med.fsu.edu). DOI: 10.1097/PHH.0b013e3182800173 Copyright © 2013 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited. 483