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Nip staff squabbles before they escalate

Practice Management. By Julie A. Jacob, amednews staff. Feb. 25, 2002.

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One of your employees complains that another employee always leaves 15 minutes early and doesn't finish his work, but the other one counters that the complainer takes extra long lunches.

Or your 60-year-old office manager informs you that the 20-year-old receptionist you just hired is sloppy and listens to horrible music on the radio, but the receptionist tells you that the office manager is impossible to please.

As a busy physician, you probably don't feel like you have the time or energy to deal with staff squabbles. But if you allow conflicts to fester, the outcome will be sagging morale, a drop in productivity, and even the loss of good employees.

"When my two assistants don't get along, my schedule gets off and work doesn't get done," said Alecia Hathaway, MD, medical director for the Tarrant County (Texas) Public Health Dept. To reduce the chances of conflict from occurring in the first place, she holds weekly meetings that give employees a chance to talk about what they are doing, air concerns and build teamwork among her staff.

"Once you establish the group as a team it becomes a cooperative family setting," said Dr. Hathaway. "It helps reduce territorialism and dumping of work and helps to build mutual respect and professionalism."

Resolve conflict effectively

The specific reason for employee disputes may seem petty, but the underlying reasons for the disagreement are much broader, said Elizabeth Woodcock, director of knowledge management for Baltimore-based Physicians Practice Inc.

Sometimes conflicts arise because one person simply isn't doing his or her job, she said. In such cases, the employee may ultimately have to be let go if performance doesn't improve.

But many times, employee conflict stems from generational or cultural friction or is a ripple effect of conflict between their bosses. For instance, said Woodcock, two medical assistants may clash because the doctors they work for don't get along.

Personal stresses can also ignite conflict between employees, said Chris Nordgren, PhD, a clinical psychologist for Avera-McKennan Hospital in Sioux Falls, S.D. He handles human resources and employee assistance issues.

"You've got things going on in a person's life with their family or friends or finances or health-related issues," said Dr. Nordgren. "Each of us brings a history with us wherever we go -- patterns of interacting, work habits and so on -- all of those things come together."

Whatever the cause of the dispute, it's important for the situation to be defused quickly before the conflict drains the morale of the whole team.

In some cases the employees can settle it on their own. In other cases someone needs to intervene. In large medical groups, the office manager can settle many employee disputes. But physicians in solo or small group practices without office managers will have to step in themselves. In addition, sometimes the office manager may need to turn to the physician for support in handling the matter.

Dr. Nordgren said that these tips will help make the process of resolving the conflict run more smoothly:

• Pick a non-stressful time of the day and week to talk to the employees about the situation. "When people are under less stress, they'll be more receptive to what you say," said Dr. Nordgren.
• Ask each employee to sum up the problem in two or three sentences. Make sure that each employee has an equal amount of time to state his or her position. Don't let anyone ramble on.
• Briefly paraphrase what each person tells you. For example, say something like: "So you're saying, Jane, that when John leaves early, you have to finish submitting both his claims and yours. And, John, you're saying that you have to leave early to pick up your son, but that you do some of Jane's work when she takes a long lunch hour."
• Maintain a neutral expression and tone of voice. It's important that the employees don't feel like the physician is favoring one person over the other, said Dr. Nordgren.
• Be nonconfrontational. "Don't flail your arms around, point, or fold your arms like you're passing judgment," suggested Dr. Nordgren. "And don't stare them down, that's okay for a border collie, but not for people." In addition, he said, employees will be more receptive to your comments if you are at the same eye level as they are. In other words, don't stand if they are sitting and vice versa.
• Help the employees create a solution that is satisfactory to both of them. For example, Dr. Hathaway helped two of her employees who were fighting over one person coming to work late create flex-time schedules that they both were happy with.
• Reinforce good behavior. Praising employees for resolving the dispute works better than punishment, said Dr. Nordgren.

"Find ways so they see it is to their benefit to do the right thing," said Dr. Nordgren. "Their attitude will be better than if they are being punished into it."

Jacob served as a staff writer for AMNews from 1996 to 2002.

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