Of all the challenges incumbent in a physician’s daily practice, one that often stands out as particularly tough, is having those difficult conversations with staff. These can take the form of performance problems related to errors in clinical care, negative interactions between staff members, inappropriate staff-patient interactions, or unsuitable attire, to name a few. Addressing these problems can feel like a no-win situation: avoid the conversation because it is uncomfortable and so the problem persists, or engage in the conversation and have it go badly and result in unknown consequences (defensiveness, the employee quitting, the problem persisting, and/or damaging the relationship between the physician and the staff member).
Let’s look at how to have the difficult conversation AND have it result in positive outcomes. It is helpful to recognize that all difficult discussions have at their core 3 common ingredients:
• Differing perspectives between the two individuals
• Emotions get triggered, and
• The stakes are high (either the results or the relationship may suffer).
Knowing that these form the basis of all negative interactions allows us to develop strategies to achieve a positive outcome. Here are four critical strategies for engaging in the conversations:
1. Ensure that you have positive intentions for having the conversation and that you communicate those positive intentions.
2. Look for ways to minimize threat for the other person.
3. Helping a person learn and/or change their behaviors should involve less “telling” and more “asking.”
4. Focus more on the solution than the problem.
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