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Resolving Staff Conflicts Before They Boil Over


The consequences of conflicts at a medical practice are greater than any other workplace, so it's important to mediate a resolution as soon as possible.

Conflicts among staff at a medical practice are not unlike those experienced in many work environments. They range from simple dilemmas, such as coordinating vacation schedules, to the more challenging performance-based problems. However, what’s unique about a medical practice is the impact those conflicts can have.

The Exchange: A Bold Proven Approach to Resolving Workplace Conflict

“The consequences [of the conflict] are often greater because of the risk of patient harm and the question of patient safety,” says Steven Dinkin, president of the National Conflict Resolution Center, and author of (2011, Productivity Press).

With much at stake, it behooves physicians and their practice managers to recognize and mediate a resolution before the conflict boils over.

Start with communication

The key to conflict resolution is communication. Christina Stovall, MBA, PHR, director of the Human Resources Service Center at Odyssey OneSource, says that employees may not always like what you have to say, but it’s important to make sure they hear it, even if it’s negative news.

“Whether it’s little team huddles at the end of the day or email communication, it’s important to make sure everyone is on task and still has the big picture in mind,” Stovall says. “Open communication and dialogue helps clarify the goals that you’ve set for the practice, and it helps hold everyone accountable.”

Stovall explains that in addition to communication, hiring the right people for the practice is key — and that starts with having a trusted practice or office manager. Trusted office managers, she says, are worth their weight in gold. If they can run interference and head off issues before they reach the doctor, that’s the best thing you can ask for.

“Performance management is a daily task, a daily function,” Stovall says. “It shouldn’t happen once a year. Employees should always know how they’re doing. And when hiring people, if you have a reliable office manager — a person with a good feel for the pulse of the practice who knows the different personalities — you can ensure the right mix of people.”

Mediation process

The National Conflict Resolution Center has developed a process called The Exchange, which is currently being used in many workplace environments, but according to Dinkin, is especially important in the health care field. He explains that the Joint Commission is now requiring that hospital systems and health care facilities have a conflict management system in place to address issues so as to minimize the impact on patient safety. The Exchange, he says, has been designed to exceed the Joint Commission standards and is based on mediation principles.

In the traditional mediation process, the mediator facilitating the negotiation is completely neutral. With The Exchange, the doctor or the person facilitating the mediation has a strong voice in the decision-making process so that it meets the standards of the office. But the idea, says Dinkin, is that the two parties involved in the negotiation have strong involvement as well.

“They’re working toward the resolution; they’re working through the issues, so that when they come to an agreement, ideally, it will be more sustainable over time because they’ve had an active role in coming up with the resolution,” Dinkin explains. “And the fact that they’ve gone through the process, the next time an issue arises they’re going to be much better equipped to address the issue themselves rather than having to go back to the physician.”

Uncover issues early

Just as with early diagnosis of an illness, the chances of successful conflict resolution increase by being preventative and identifying issues at their earliest stage, according to Dinkin. Too often these conflicts boil over because managers tend to avoid them or don’t have the confidence to address them. The consequences of conflicts boiling over can be especially intractable in the health care field.

“If you lose a skilled nurse, if there’s a lot of turnover, the time it takes to train a new person, and the costs involved with that, are sometimes greater than other industries because of the skilled quality this employee must have,” Dinkin says. “So, even if there’s no dispute, people might just have different perspectives, which often times is a positive thing. But you need to be able to reconcile those differences so that people can work together toward a common goal. The Exchange is an easy strategy to learn, and it gives the manager or the physician the confidence to address matters early on.”

Ed Rabinowitz is a veteran healthcare writer and reporter. He welcomes comments at edwardr@frontiernet.net.

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