For Healthcare Professionals Only
Conflict is par for the course in any partnership, whether professional or personal. How you handle conflict, though, can have a significant impact on the future of your practice.
Anyone who has worked in a practice where problems are handled poorly between partners knows the tension such arguments can create — and not just for partners, but between other staff members as well. Arguments have driven many practices into the ground. Physicians, and even practice managers, who tend to avoid or ignore problems may be unintentionally “poisoning” the working environment in their own practices.
"Chaos rules these organizations," explains John-Henry Pfifferling, PhD, founder and director of the Center for Professional Well Being in Durham, N.C. “Policies are either not clarified or changed at a whim. Roles are not spelled out or vary enormously. Expectations are unclear or unrealistic. Employees are subject to impulsive actions, have no sense of stability, and may feel forced to conform to the control of one or a few people.”
In one practice Pfifferling visited, anyone who challenged the authority or judgment of a particular physician was personally attacked. At another practice, new employees were told during orientation that sharing ideas and brainstorming were unacceptable. “Rarely did we find compliments extended in private or in public,” says Pfifferling. “No news was good news.”
Although these are extreme examples, Pfifferling believes the problems of these practices have the same root as problems at many dermatology practices: poor communication.
"Assertive communication is a commitment to promote equality between [partners]," says Pfifferling. "Practices that promote effective communication, along with conflict resolution and professionalism, promote optimal health — both for patients and for themselves."
Here are Pfifferling’s suggestions for practices that want to promote a positive work environment and a healthy relationship between partners:
Define professional conduct. Although behaving professionally may seem like common sense to most of us, Pfifferling notes that many practices don’t address behavior at all. Others may address professionalism in general but are not specific to the practice. Many practices don’t even have a manual outlining items specific to physician-owners! Address in writing any professional requirements your practice may have, and be sure partners know the requirements apply equally to everyone.
"For instance, what is a timely response to patient and staff requests?" says Pfifferling. "A clear definition of what the practice considers acceptable behavior provides credibility if you have to confront someone later."
Pfifferling also suggests developing language about interpersonal behavior. “What behavior should employees refrain from? Possibilities include sexual innuendoes and sexual harassment, abusive language, sarcasm, racial and ethnic slurs, and threats of violence, retribution, or litigation.”
Set clear expectations. Beyond a general expectation of professional behavior, each partner should be expected to meet certain criteria. Be explicit about what tasks and duties are required of everyone. Whenever possible, set firm goals that partners need to meet or maintain, and be sure to commit those goals to paper so they can be reviewed and revised later on. Setting expectations produces measurable performance objectives and creates ownership of specific responsibilities.
Practice partners can avoid potential arguments by clearly outlining what is expected from everyone at the start. Pfifferling suggests discussing everything from how long physicians should take to answer a page to more complex issues, such as the overall vision and direction of the practice. “Talking now prevents confusion and disagreement in the future,” says Pfifferling.
Evaluate and self-evaluate. Setting goals and making plans are pointless unless you take the time to measure how close you are to meeting or exceeding your objectives. Annual evaluations are a good time to review performance objectives and professional expectations with practice employees, but regular, less formal meetings also can reinforce employee goals. Practice partners, as well as the practice administrator, should meet regularly to discuss both the status of the practice and its future.
Pfifferling also suggests that people spend time on self-evaluation. "Ask yourself how you’re doing," says Pfifferling. “How am I doing as a partner? How well is the group fulfilling its mission? Is there something else I could be doing, something that would make things smoother?”
Talk about issues. Avoiding a problem will not make it disappear, and very often such behavior only exacerbates an already bad situation. Practices that promote conflict resolution understand the need for employees to talk about whatever issues are troubling them.
That doesn't mean partners should corner each other in the hallways, says Pfifferling. Instead, he suggests holding a meeting on neutral ground, or taking time during regular status meetings to discuss potential problems. As long as the focus of the discussion is on solving the problem—not on assigning blame, finding fault, etc. —communication can lead to improvements.
Don’t use e-mail for problems. It's very tempting to address practice conflicts through e-mail, but Pfifferling encourages face-to-face contact. Emotions can run very high during conflicts, and e-mails can be easily misinterpreted. “Use e-mail for basic things, like setting call schedules or sending status reports,” suggests Pfifferling. Bigger issues need to be handled in-person.
Use a mediator. There are times when partners, and even other employees, simply cannot reach an agreement. If you have tried to come together for a solution and are still not able to resolve the problems between you, it may be time to consult with a mediator.
"Use e-mail for basic things, like setting call schedules or sending status reports." John-Henry Pfifferling
Pfifferling recommends the mediator be a third party who is unbiased about the issues at hand—and that usually means someone who is not connected to the practice in any way. Practice administrators or other partners all have vested interests in how conflicts are resolved, and they easily can feel pressured by friendships, loyalties, professional or personal obligations, and other factors. A professional mediator, however, can be objective and is trained to help both parties keep communication productive.
Just in case there are dermatology practices unsure about implementing these suggestions, Pfifferling has a final few words of advice. "Patient advocacy groups are demanding better interpersonal skills from their doctors," he warns. "Attorneys are holding practices liable for tolerating disruptive behavior by employees. Clear and honest communication is now demanded by everybody involved in patient care."
CONTENT PROVIDED BY:
Disclaimer: The material above has been prepared by Physicians Practice. It has not been reviewed by the DermQuest Editorial Board for its accuracy or reliability. Reference to any products, service, or other information does not constitute or imply endorsement, sponsorship, or recommendation by members of the Editorial Board.