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How to stop staff infighting


Employee conflict leads to high turnover and alienates patients. Here's how to achieve détente.

Key Points

Consider the case of Paradise Primary Care, a three-doctor group consisting of two senior partners and an employed physician. A nurse and part-time biller gossip incessantly about other staffers, and each day is marked by arguments and distracted employees who let personal problems interfere with their work. The senior physicians, both nonconfrontational types, don't want to fire or offend anyone, so they're reluctant to step in. Instead, they hire a consultant, who interviews front-and back-office staff, documents areas of friction, and hosts a communications seminar for the entire group. Calm is restored for a couple of months, until the head biller's abnormal Pap results-which she had faxed to the office-are intercepted by the part-time biller and broadcast throughout the office. Humiliated, the head biller quits and threatens to sue for a hostile work environment.

Undeniably, there's trouble in Paradise.

The name is fictional, but the group where this scenario played out is real. One of its senior partners, a veteran family physician, characterizes the damage done by gossipy, argumentative staffers as "irreparable"-and the main reason Paradise Primary Care has had problems retaining key workers. Moreover, "patients overhear staff conversations, sense the bad mood among the receptionists, and conclude that they're more interested in undermining each other than in helping patients," the doctor says.

First, recognize that no practice runs entirely free of dissension-and that even the best managers can't prevent occasional worker vs worker friction. What's more, the tendency to gossip is an intractable aspect of human nature (it isn't hard to picture Caveman 1 and Caveman 2 whispering about Caveman 3's poor boar-hunting skills). When the bickering becomes mean-spirited or constant, though, it's time to step in, to identify the sources of friction and keep minor squabbles from erupting into full-blown battles.

Remember, too, that you lead by example. "You can't develop a successful team unless you behave as you want your employees to behave," says Charles L. Sodikoff, a psychologist who specializes in work team and conflict-resolution issues and is located in Merrick, NY. "Physicians and office managers who participate in gossip sessions and indulge in blaming and finger-pointing tacitly condone those behaviors as accepted elements of the office culture. 'Do as I say and not as I do' is as unacceptable in managing others as it is in parenting."

Additionally, recognize that there will be times when you'll need to get involved. "One of the key problems I've witnessed in medical practices, especially small ones, is that physicians define their roles too narrowly," says Gena Cox, an industrial psychologist and executive coach with Human Capital Resource Center in Tampa, FL. "Doctors often assume that because their main job is to deliver medical services, they shouldn't have to deal with employee friction, so they let it go on for too long." The key to a congenial workplace, Cox and others agree, is early intervention.

Finding the sources of interoffice strife

One of the central characteristics of office friction is that troublemakers tend to stay on the job while victims-some of whom might be your most knowledgeable and efficient workers-leave. So if your practice is marked by discord and tension, you or your office manager needs to determine who the perpetrators are, and deal head-on with their behavior.

You don't need to investigate every churn of the rumor mill or step in whenever you overhear one employee criticizing another. But you are obligated to check out reports of malicious gossip, bullying, racial or ethnic slurs, verbal abuse, harassment, and other deliberately hurtful actions. And you're also obligated to create an environment in which staff members feel welcome to come to you with reports about such behavior.

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Jennifer N. Lee, MD, FAAFP
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health