One of the most unpleasant – if not dreaded – facets of management is dealing with conflicts. In a medical office, they come in one of three forms. They are conflicts between staffers, between staffer and manager, and between doctor and manager. And each gets handled in a different way.
1 Staffer versus staffer
Staffer and staffer conflict becomes apparent a number of ways. One side comes in complaining about the other. Or one says something in a meeting and the other argues. No manager wants to get into the middle of that. But if it’s allowed to go on, the other staff can get irritated with it or even drawn into it, and productivity declines.
The approach: Talk with each staffer individually and get both sides of the story. Then bring the two together to hash it out. But do the hashing somewhere other than in the manager’s office, because in that venue, the issue takes on formality. Don’t give it that much status.
Tell what effect their war is having on the office, perhaps that the other staff don’t like working around the friction or even that a patient has commented on their rudeness to one another.
Then proclaim neutrality: “I’ve heard your stories, and I assume the truth is somewhere in the middle. Don’t look to me to take sides. I’m counting on both of you to see this issue from the other person’s point of view and work it out.”
Turn to one staffer and say, “Tell your version of what happened.” The answer might run along the lines of, “I asked her if she had seen my report, and she just ignored me.”
Then ask, “How did that make you feel?” It’s not the facts that cause conflicts but the emotions they bring out. If the answer is, “It made me feel stupid and unimportant,” that’s the cause of the conflict. Now turn to the other side and repeat the same two questions using the very same words and the very same tone as before. Don’t say, “What do you have to say about that?” or “Why did you act that way?” That’s accusatory and gives the first staffer the winning seat.
Suppose the answer is, “I was in the middle of a phone call. I couldn’t talk, and she was very rude.”
Follow again with, “How did that make you feel?”
Sometimes that’s enough for the two to see the light and apologize and go on their way. But sometimes not. The two may keep talking. Let them. If the conversation is fruitful and they are explaining the situation to one another, say, “Tell me more.”
If the conversation heats up, cool it down by asking about a question such as, “What time of day did this happen?” or “What was the report about?”
The goal is to get them to say, “I understand.” At that point, there may still be a conflict, but now it’s rational and logical.
What if no solution appears? Ask each side, “What is the one thing you want to come out of this?” or “What do you want from Staffer B?”
If one says, “I want an apology,” ask the other if that’s possible: “Do you acknowledge that perhaps you could have handled this better?”
What if there’s no relief in sight? Stop the meeting and tell them to think about the issue and come back in an hour to continue the discussion.
And once the issue is settled, send the two away with praise: “Thank you both for being open minded and working through this.”
2 Staffer versus manager
Staffer/manager conflict usually crops up when a staffer gets miffed about something the manager did, medical office manager didn’t do, said, or didn’t say. And rarely is there confrontation. The staffer simply detaches in little ways such as not saying hello in the mornings – and the hint is dropped!
Break the ice, but not with a sledgehammer: “Do you have a problem with me?” or “What’s wrong with you?” The answer will invariably be, “There’s no problem.”
Approach it instead with an invitation to a dialogue: “I sense there is a rift between us.” (A rift says it’s something that’s easily mended.) “Help me understand what’s going on.”
Whatever the answer, acknowledge the personal feelings, however unjustified they are: “I can see how you could feel that way” or “I had no idea you thought I was angry with you.” That’s no admission of guilt. It just acknowledges the staffer’s feelings. Then explain the behavior: “This is my perspective of what happened.” And then apologize – not for having done anything wrong but because it made the staffer feel bad: “I’m sorry that what I did made you feel that way.” End by thanking the staffer for “working through the rift.”
Quit right there. Unless the conflict reappears, don’t bring it up again.
To a great extent, the success of any meeting with a staffer that could be confrontational depends on the manager’s body language. It has to indicate that the manager is willing to hear and consider what the staffer has to say and is open to suggestions. Don’t cross the arms or the legs.
Don’t sit across a table from the staffer, because the table serves as a barrier. Instead, sit side by side and face the staffer with not a lot of body under the table.
Leave only enough space between the chairs so that either person could reach over and touch the other’s knee, she says. And if the staffer wants to move a little closer, okay. That’s far enough for comfort but close enough to put manager and staffer on the same level, and the table serves as a security to both. Make eye contact, but don’t stare. And if the words don’t come readily, admit it with, “Please give me a minute. Let me think how I want to say this.”
3 Doctor versus manager
Doctor/manager conflict is another story entirely. Stay away from the emotions, stay away from being understanding, and stick to the facts. Doctors deal with facts and statistics, not emotions. They don’t want to hear a sensitive, “When you did X, it hurt my feelings.”
Neither do they appreciate signs of weakness such as downcast eyes. And neither do they want to hear somebody beat around the bush and waste their time.
Talk in bullet points and hit the soft spot: how the situation is hampering the manager’s ability to do the job and thereby affecting the office’s bottom line. Say, for example, “When you are gruff and preoccupied, I can’t ask you about office issues, and those issues don’t get addressed as quickly as they should.”
From there, ask for a solution. But don’t put the responsibility on the doctor with, “What can you do about this?” Shoulder the responsibility with, “What can I do?” or “How should I communicate with you if this happens again?” That’s managing the boss.
The conversation will probably end right there. The doctor will either explain what to do or say, “OK, I was being a jerk. Next time just tell me it’s important.” Once again, the proper ending is, “Thank you for working through this with me.”
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