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Kurt Scott, Founder, CEO, Physician Leadership Career Network, Tampa, Florida
You like the medical practice or organization you work for, and you love what you do. But there is a physician, administrator, or another clinician making it more difficult for you to come to work every day. How do you effectively deal with "that person" without creating World War III?
I've had to deal with this type of issue throughout my leadership career. It wasn't easy. In my early years, I would avoid conflict of any sort, and at all costs, even to my own detriment. I would almost rather have gotten my head stuck in a vise than to deal with conflict. After I ran through the different scenarios a million times in my head, I was fairly sure it would end up in full-on fisticuffs.
After all that agony, here's what I learned: It's never as bad as what I built it up in my mind to be. Now, I am completely comfortable with it; I still may get a case of nerves, but it's still a far cry better than before.
In my opinion, confronting a colleague or teammate who consistently exhibits bad behavior ranks right up there as one of the most anxiety-provoking situations we must deal with in the work environment. But there are many effective ways to deal successfully with this situation.
Do you have to bring in your supervising physician or the human resources (HR) department? There might have been a day when the mere mention of HR would cause trepidation, but not so anymore. HR has evolved over the years and can be hugely helpful in these kinds of matters and provide much-needed advice.
I had the opportunity to chat with a well-known consultant to healthcare organizations, Quint Studer. Studer is a Pensacola, Florida, businessman and philanthropist and founder of the healthcare consulting company Studer Group, as well as Studer Community Institute, which specializes in leadership training. He's the author of The Busy Leader's Handbook: How to Lead People and Places That Thrive. I asked Quint about ways to approach and dismantle a caustic relationship and potentially even turn it around.
Most issues can be dealt with in a one-on-one conversation. How?
Studer said it is important to not procrastinate. "Nip it in the bud," he advised. He explains that in healthcare, sometimes physicians become masters of workarounds. In most cases, it is about providing quality care for patients, and in many cases it could mean the difference between life and death. Workarounds are what many physicians do. In this case, though, the reality is that there are no workarounds. Not addressing the issue will let things fester and get worse. One saying that sums it up is, "What we permit, we promote."
Studer recommends a progressive approach to defusing the situation. First, hold up the mirror. Ask yourself, "Could I be contributing to this issue?" When we make an effort to become more self-aware, we may start to see things differently.
Beyond that, don't assume the person is even aware of what they are doing that's creating the issue. Many people have been approached about unpleasant or troubling behavior and have been completely surprised that people are offended. I will add, you probably don't have a clue as to what may be going on in this person's world. The era we are all living in has many on edge (COVID-19 and quarantining, isolation, politics, and more). Keeping this in mind will help you approach them with a higher level of sensitivity.
When talking to the person in question, try and use reward and recognition. Studer explains that building up the person a bit — showing them some respect and recognition — allows you to approach them with the issue. He maintains that we need three positives to negate one negative. Studer calls this the "spinach in the teeth" conversation. If you care about someone, you will tell them about what's stuck to their front tooth, even though it may be a difficult or embarrassing conversation.
This way you can approach your colleague in a consulting way instead of a scolding and possibly demeaning way. No one likes being forced into a back-against-the-wall position. You don't want to foster a defensive posture. Studer calls the first type of approach the "cup of coffee." After using some honest kudos regarding things you like about the person as a physician or skill sets you admire, you can then start the consulting part with such phrases as, "I care about you. May I give you some feedback?" or "I know you are not aware of this but…"
Although it may be tempting, when dealing with this issue, it's important to not go through someone else! It's far better if you do it one on one.
I will add: Do not make the mistake of taking on the role of spokesperson for your entire team and, by doing so, throw others under the bus. You must be speaking for yourself. Don't say that others have noted or had problems with this behavior.
Studer says that in the majority of cases, this conversation will resolve the issue and the person will change their behavior by now being aware of what they are doing or saying. If they don't completely change their behavior, it's still likely that they will make the effort. If you see that happening, it's helpful to thank or show appreciation for the person's efforts.
It's possible the person will come back and say, "If you don't like it, then it's your problem." If they do? Then it's time to elevate the conversation to what Studer calls "support-coach-support."
Again, start with positives. Support the colleague or team member with positives like how valuable they are to the team or how you have valued their expertise in (fill in the blank). Then you can gently work in, "but things have to change." Explain again what they are doing or saying that is creating the issue for you. Then end with additional support, such as "I know you are a good person and will be able to change this behavior, and our office and team morale will be stronger for it."
And what if things do not improve?
Studer's end-of-the-rope conversation has the acronym DESK.
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D escribe the behavior. Let them know it has gotten worse.
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Evaluate what you have discussed with this person and why it is not acceptable.
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Show them what right looks like. Give them examples of appropriate behavior.
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Konsequences (Yes, I know it's not a C.) Tell them exactly what will happen if it happens again. You may have to elevate the issue to your chief, chair, or CMO or the HR department. I will add: Do not use idle threats. If you say it, mean it. If you don't follow through, you've lost your credibility.
I also believe it is important to not skip steps. Don't jump to the final conversation first — or even worse, go to the final conversation then try and back up to the first conversation. I think it's akin to waking up in the morning with ground coffee beans and no filters. You need all the tools in place to be successful.
One caveat: If what you are dealing with involves serious issues such as abuse or harassment, skip to that final conversation. If the matter is severe enough, go right to your supervising physician or HR.
Where should these conversations take place?
My preference is to have these types of conversations in a low-traffic area, such as your office. If the issue arises in front of others, addressing it in front of the bystanders will push the person up against the wall. They may very well flip on the defensive switch and come out swinging. Instead, quietly ask them to step away from the rest of the folks in the area and discuss. Use Studer's first approach.
Remember some of Studer's words of wisdom: "High-performing teams confront each other when needed. They also lift each other up with support. This is what separates them from the rest."
Kurt Scott is founder and CEO of Physician Leadership Career Network.
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