By Daniel A. Bobrow, MBA
President, American Dental Company
Part two in a series of two articles
In last issue’s article, we discussed models and tenets used to resolve conflict. In this part, I’ll go over the skills necessary that, once mastered, can greatly assist you in managing and resolving conflict in your office.
Truly listening and showing with your body language a sincere desire to know what the person is saying is vital. A person must feel that they are being heard for any resolution of any conflict or problem to occur. This can be further demonstrated by some of the points below.
Restating conceptually what is said to you to confirm your understanding. Care should be taken to “neutralize” statements by eliminating or changing words that are emotionally charged or are accusatory.
Another method has to do with understanding and matching the tone and pacing of a person’s speech pattern, and, if needed slowing it down. The goal being to calm the person so a more productive conversation may take place.
This is an abbreviation for Best Alternative To a Negotiated Agreement. It involves asking the person to consider what the best possible outcome will be if a mutually agreeable settlement can not be reached. An example of the use of BATNA is: “Joseph, I know you don’t like making reactivation calls in the evening. But you’re the only one on our staff who is capable of doing so. And you remember the mess we were in before we brought you on. What do you think will happen if we just stop doing this?” Embedded in this sentence is another technique called stroking (see below).
Similar to BATNA, reality testing attempts to get the person to see that his or her proposed solution is unrealistic, or at least, not optimum.
Blame Yourself, Not Others
A great way to neutralize tension during the mediation session is for the mediator to take responsibility for any misunderstandings or uncomfortable situations that might arise. For example, if a party grows impatient while the other party is speaking, you might say “I’m sorry for not giving you an opportunity to speak, Sam. Just as soon as Bill finishes, you’ll have your chance.”
Ask “Harmless” Questions
Ask “leading” questions: especially when the parties seem to have reached an impasse, ask “safe” questions that get the parties talking again. For instance, you might say “Whose turn is it to get lunch today? I’m starving!” or “By the way, did I remember to thank you both for helping me juggle those four patients this morning? I owe you for that one!”
Let the parties know that they’re doing a great job in the mediation, and you really appreciate their willingness to sit down and talk things over. It’s too bad more people are not willing to talk and listen.
The goal of all the above techniques is to get people to see for themselves why resolution of the conflict is in everyone’s interest, including theirs. If someone feels that they are being manipulated, or that a solution is being forced upon them, the parties to the conflict will be less likely to adhere to the proposed agreement. Remember that agreement is not the sole criterion of success. In fact, if either party feels the agreement is “forced on them,” it may do more harm than good.
An Ounce of Prevention
One way to deal with conflict is to create an environment where it is less likely to arise. One way to do this are to anticipate the kinds of conflict between staff members, doctors, and patients, then implement systems and training to prevent these situations from arising. Examples include:
“Personality Conflicts” between staff
Implement some form of compatibility assessment into your employee screening procedure, as well as for current employees. Doing so can help you understand who is most suited for working with whom. Employ active listening and caucus tools (see part 1, last issue).
“Trust is an essential ingredient of a productive and profitable environment,” says Dr. Ira S. Wolfe, DDS, president of Success Performance Solutions. “The willingness of people to exchange ideas and collaborate is thwarted when people are selected and promoted on the basis of skills and experience alone. ” People have to be able to get along with their co-workers in order to have a winning team environment. Wolfe’s SMARRT management process encourages and facilitates matching people who are compatible with the job, the team, and the practice culture. There are also testing procedures that help choose the right person for the right job and assesses their potential compatibility with other staff. Find some technique, test, or company who has experience and proven results in this area to help you with this. Doing this properly will result in less conflict and stress, and higher practice productivity.
Patient Complaints about being kept waiting
Implement a policy of notifying patients in advance if the doctor is running late. Promote a “no waiting policy” as part of your mission statement or declaration of principles. When the occasional complaint does occur, be prepared to use disarming verbiage such as “The doctor asked me to apologize to you for not being able to see you. He is busy with a procedure that has proven more involved than we anticipated. He assures me he will do everything he can to see you as soon as possible. Is that acceptable to you Mr. Jones?” Doing so before the complaint arises in the first place is a great way to show your sincere concern for your patient and respect for their time.
Staff Member refusing to implement changes or “grow with the practice.”
Caucus with that person employing the techniques covered above. Through good communication and active listening you can get to the source of this team member’s unwillingness to work with the team. In many cases, you may discovering something more fundamental going on that has farther reaching implications for the practice.
Another way of preventing conflict is to hire, then educate and motivate staff members to recognize the value of the work they do, and the value of the practice to its patients and the community. Involvement in charitable groups, for instance, can give the practice team a sense of shared pride, and serve to put in perspective the disagreements as self-indulgent exercises that neither the practice nor staff members can afford.
As I am writing this, I am experiencing a poignant example of potential for conflict. I am working on my laptop on a return flight from a conference I’d attended. A rather ample gentleman was seated in front of me. As he reclines his seat, my laptop is thrust into my abdomen. I struggle in vain to position the laptop in a way that will not restrict my breathing. Out of desperation, I at last say, “excuse me sir, I’m sorry to distrub you, but I wonder if it would be possible for you to bring your seat back up just a little bit and still remain comfortable. I realize these seats were not designed with the use of a laptop in mind, but it would be a great help if I could continue working on this article as I am under somewhat of a deadline.” He was immediately accommodating.
In addition to my choice of words, the fact that I had earlier helped this same gentleman avoid a bump to his head by pointing out the open overhead cargo bay no doubt set the stage for his cooperation. As to what I said, I was careful not to use accusatory or demanding language that suggested blame or that I was entitled to anything. I also showed a respect for his comfort, and directed the cause for the situation to the design of the seats. Finally, I offered a reason why I needed to continue my work.
Remember, an agreement needs to last, especially if between staff members.
A number of resources are at your disposal if you would like to learn more about how alternative dispute resolution (ADR) can help you achieve more harmonious relations in your practice. Which are appropriate depends on factors such as the number of staff members and the types of conflict you experience. I invite interested readers to contact me if they would like to learn more about these powerful techniques.
Daniel A. Bobrow, MBA is president of the American Dental Company, a Chicago-Based Consultancy serving the dental profession. He has mediated and arbitrated various cases. He is also Executive Director of Climb For A Cause, a non-profit Foundation whose mission is to provide health care treatment and education to people in need worldwide. He may be reached at 312-455-9488 and