From Conflict to Collaboration: Overcoming Challenges with Your Staff
As a cardiologist in practice for nearly 30 years, I was fortunate to work with a fantastic team of nurses, medical assistants, and office staff. I give much of the credit to our no-nonsense in-house nurse manager. But not all physicians are so lucky. And even one bad apple can make going to work a miserable experience.
Although medical training involves teamwork, it’s uncommon for physicians to learn managerial or business skills during medical school or residency. If you’re learning on the job, getting off on the right foot can impact your experience at work for years to come.
Until my practice was acquired by a larger organization, I served as chairman of our Human Resources (HR) committee for a number of years. So if you’re a physician dealing with challenging staff members, I’ve got some expert tips and insight to help you get to the other side of this common problem.
First, a little perspective. In years past, most physicians owned their practices. So in these situations, the physician or a trusted administrator typically did the hiring and firing. And the staff understood that keeping up good relations with their physician-employers was vital to maintaining happy employment. Now that most physicians are themselves employees, the relationships have become more muddied. And the truth is that depending on your organization, you may or may not have much say in the way the practice is run.
Be that as it may, as a physician, your leadership is crucial to maintaining a good working environment. Whether it is implicitly stated or not, your staff should understand that their job is to support the work that you do. And ultimately, that means providing optimal care and a supportive experience for your patients.
Whether you’re employed or not, your patients depend on you for your expertise and your care. Your employment status is irrelevant to them, and they view your staff as an extension and a reflection of you. That means that if the practice feels chaotic and uncomfortable, your patients are likely to feel unsafe and unwelcome.
It’s likely that most of your staff will appreciate a physician who is kind, principled, and clear. Most people who work in healthcare take pride in their jobs and care about the people they serve. But unfortunately, you can also expect to encounter some difficult folks along the way.
To maintain your sanity, your ability to provide care for your patients, and your role as a team leader, it’s important to have a clear plan for dealing with troublemakers.
Some people may be negative or disruptive, others may be passive-aggressive, and some may simply be incompetent. You may even encounter employees who delight in getting you upset. Regardless of the type of difficult staff member you are dealing with, rule number one is this: do your best to remain calm, cool, and professional at all times.
When dealing with the inevitable conflicts and other tough situations at work, here are some important things to keep in mind.
Don’t make it personal
Although it can be tempting to let your emotions take over, the minute you make it personal, the problem becomes about you. This can be very difficult if not impossible to turn around. By keeping it professional, you have a much better chance of remaining above the fray.
Consider involving HR:
If you have access to an HR staff member or administrator, and you feel reasonably confident that they will support you, it’s best to involve them early on in a difficult situation. This can help to protect you from accusations of harassment or favoritism.
When you try to go it alone, especially as a new physician, there’s a good chance you will end up making some important missteps. Never underestimate the power of a passive-aggressive or disgruntled employee to undermine your reputation. In the worst cases, this could mean the loss of your own job.
Document everything
Documentation is not necessarily to get the employee in trouble. You’re documenting in order to protect yourself.
Be sure to include the specific behavior that is causing the problem, the date and time of the incident, and any steps that you have taken to address the problem. It’s a good idea to make a note of any witnesses as well.
Try to understand the root cause of the behavior
Although your practice’s administration is likely responsible for managing the employee and their disruptive behavior, getting a handle on the behavior and its root cause may be helpful. Once you understand this, you may start to develop a plan to turn things around.
For example, if a staff member is negative and disruptive, it may be because they are feeling overwhelmed or undervalued. That doesn’t mean that you need to acquiesce to their demands or accept the behavior. But understanding what might be contributing will make it feel less personal. It may also give you insight into the path forward. And armed with this information, you may be able to work more collaboratively with your administration.
Be direct and honest.
If your administration takes a hands-off approach, it may be left up to you to manage the issues. This is often the case for minor procedural problems, lack of education, and misunderstandings.
When you address the problem with the staff member, be clear, calm, and truthful. Avoid being confrontational or accusatory. Instead, focus on the specific behavior or issue that is causing the problem and how it is impacting the workplace.
Consider having a trusted colleague or nurse present for the discussion. That will help to protect you from any undue accusations.
Be prepared to offer a solution
It may be necessary to work directly with the staff member to resolve the problem. For example, if a staff member is struggling with a particular task, it may be up to you to provide them with additional training or support.
Set clear expectations and provide regular feedback. Sometimes these individuals become the most loyal employees, if they understand that you are on their side.
Be supportive and encouraging
The process works both ways. By contributing to a work environment where your staff members feel valued and supported, you are more likely to be listened to and treated with respect.
Be fair and consistent
Treat each of your staff members fairly and consistently. Avoid favoritism and keep your personal life separate. When you spend most of your life at work, it may be tempting to see your staff as friends. This is a pitfall that many early career physicians fall into. Over time this can create divisions and expectations that will only make things more difficult for you.
As a physician, you have the right to expect a positive and productive working environment. If a staff member is making it challenging for you and others to do your jobs, it’s critical to take the necessary steps to address the problem. Whether that means involving administration, providing additional training opportunities, or even terminating the employee, embodying a calm and professional leadership style will help to ensure a safe and supportive environment for you, your staff, and your patients.
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