How Do You Use Your Power?
- 4 days ago
- 3 min read
Updated: 1 day ago
At THC Primary Care, we create resources for primary care leaders, provide interim primary care network management and facilitation. In this blog, we are covering the subject of power and how we use it.
Whether you're navigating neighbourhood working, trying to improve relationships with your GP federation, strengthening collaboration within your PCN, or even working through dynamics in your own practice, this question matters. Because how we use power shapes everything.
The Four Types of Power
In the book Dare to Lead, Brené Brown explores four types of power:
Power over — using power to control, coerce, or dominate others. The traditional hierarchical model, where power maintains authority.
Power with — shared power built through collaboration and mutual respect. Finding common ground and working together toward shared goals.
Power to — the capacity to act, create, and make things happen. Agency and the ability to shape your own circumstances.
Power within — internal strength rooted in self-worth, self-awareness, and values. The foundation of grounded confidence.
When I first heard this framework, I made a note of it immediately because it gave me language for something I'd been observing for years.
Most of us would say we aspire to "power with." We want to collaborate. We want shared decision-making. We believe in collective voice.
But here's the uncomfortable truth: "power over" doesn't always look like dominance.
Sometimes it looks like absence. It's saying no without ever actually saying no.
Power in Disguise
I'm sure you will be able to relate to some of the following behaviours.
Not making time — controlling the diary. "I'm just too busy" sounds reasonable. But when it's a pattern, it becomes a form of control.
Disengagement — agreeing to be part of something but refusing to participate meaningfully. Present but not engaged.
Not reading the papers — unable to contribute to decisions, then blaming the meeting for being a waste of time.
Deferred decisions — "I'll need to take that back to my partnership" as a permanent holding pattern. Nothing ever gets agreed.
Post-meeting objections — silent in the room, vocal afterwards. Undermining without direct accountability.
Rotating attendees — sending a different person every time. No continuity, no ownership, no one who can commit.
Information withholding — not sharing data or context that would help collective work, because knowledge is leverage.
These behaviours might be genuine overwhelm or circumstance. Or they might be "power over" exercised through absence — control without ever having to openly oppose anything.
The point isn't to assume the worst. It's to notice the pattern.
What About Your Power?
It's easy to spot power dynamics when you're on the receiving end.
It's harder to notice when you're the one wielding power consciously or unconsciously.
So I'm inviting you to get honest with yourself.
If someone wants to meet with you and you're avoiding it — why?
What's really driving that? What has happened in the past? What are the stories you're telling yourself about this person or this situation, and what's actually fact?
What position are you trying to maintain? What are you frightened to give up?
How could your behaviours be perceived by others?
Are you willing to move forward?
What are the implications of your actions, and do you care about those implications?
Are you the victim in this situation?
What are you in control of that you could change or influence?
And underneath all of it: What sort of leader do you want to be?
The Real Work
There's no shortcut to navigating power dynamics.
What there is: the willingness to notice patterns, name them honestly, and choose consciously how you want to use your own power.
Power over? Power with? Power to? Power within?
How do you use yours?
Work with us
If your network’s facing unproductive meetings, unclear goals, or ongoing tension, you don’t have to navigate it alone. Our facilitation services help PCNs tackle challenging conversations, clarify shared purpose, and establish decision-making frameworks that work for everyone.
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About Us
THC Primary Care is an award-winning healthcare consultancy specialising in Primary Care Network Management and the creator of the Business of Healthcare Podcast. With over 20 years in the industry, we've supported more than 300 PCNs through interim management, training, and consultancy.
Our expertise spans project management and business development across both private and public sectors. Our work has been published in the London Journal of Primary Care, and we've authored over 250 blogs sharing insights about primary care networks.
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