Excellent staff members love their job, their role and their responsibilities in practice. However, when their role is compromised by frustration, conflict creeps in and, ultimately, it's the patients that suffer.
On the other hand, conflict that's resolved successfully can push a practice toward improved patient care and customer service and thus help the practice thrive. It leads to a happy staff, satisfied clients and a smoothly running clinic.
One thing is certain: conflict is inevitable. So in the spirit of making lemonade when we're served lemons—conflict—let's use conflict to grow and prosper.
In order to do this, practice leaders need to set up an environment that helps identify conflict in the early stages and provide systematic resolution algorithms for the people involved. But first, we need to recognize what's behind conflict.
Hints, underlying issues and recognition
When a dog gets ready to bite a human, it usually signals the intent beforehand—you know the bite is coming. Human conflict is similar; people often give off signals that precede the crisis event.
When people are frustrated, they tend to roll their eyes, engage in verbal snipping, behave in a passive-aggressive manner, give off body language cues, and—of course—give "the look."
Frustration is what drives this conflict. When we're frustrated, our adrenaline, cortisol and blood pressure levels go up and we stop having fun. Then the anger sets in, and this anger causes us to push away dialogue and resolution. Once the heat of anger is present, objectivity goes out the window.
Specifically, here are some conflict cues to look for and triggers to be aware of at your veterinary practice (keep in mind that cues and triggers are often one and the same):
Body language. Joan Guntezman, PhD, says that 85 percent of human communication is transmitted through body language—so we need to watch out for hints.
For example, incessant eye blinking and grabbing one's elbow or a nearby edge, such as a countertop or desk, can indicate anger. However, eye blinking combined with the act of constantly touching one's face can also indicate lying. Meanwhile, nervousness can show itself in the form of evasive eyes, crossed legs while standing and crossed arms with hands on the biceps.
Teasing. It's been said that all teasing contains a bit of truth—and the truth can have an edge. We need to be aware of the teasing that's going on in our practice and look for clues of distress from the recipients.
Redirected aggression. By nature, mammals redirect aggression. So when our staff is experiencing conflict, the subordinate party tends to take it out on those downstream.
Depression. Some experts have stated that 10 percent of all Americans are depressed on any given day. Translated to our world, that means one out of every 10 employees and clients will be depressed on any given day. Depression can trigger conflict; in fact, it's a huge and largely hidden trigger.
Stress points. The Holmes-Rahe Stress Scale System is a classic method used to assign life stress values to human behavior. So when staff members or clients are facing life changes such as divorce, financial woes, child custody battles or a death in the family, these will affect their ability to cope with day-to-day conflict.
Snipers. The rage in the behavior research world right now is discussion of the "sniper," an emotional sharpshooter who has the ability to produce a highly targeted emotional response—down to heart rate, breathing patterns and other effects of emotional machinery. A personal sniper in your practice will get in "digs" at every opportunity—subtle condescending comments that are very precise, perfectly timed and highly injurious.
Questions. Many questions are actually comments in hiding. We must pay attention to these, as they sometimes relate to underlying issues.
"Nevers." The "nevers" are people who have come to the conclusion that life is not shaping up in the way they want it to. The recognition that one will never achieve his or her dreams—whether or not that's actually true–contributes significantly to stress and conflict.
Passive-aggressive behavior. There is an inventory of actions that prove that frustrations lead to passive-aggressive personal conduct. The most common of these is tardiness. Other passive-aggressive indicators may include frequent opposition to higher-ups, deliberately making mistakes, letting things escalate and procrastinating on purpose.
PPFF failure. Professional, personal, fun and financial (PPFF) are the four major areas of our lives, and they each contain our priorities and dreams. When things are off track, our lives can feel out of balance, which affects our coping skills.
The practice owner or manager's game plan is simple: identify the early signs of frustration and fix them to avoid the advanced stages that lead to an explosion. The greatest challenge in conflict mitigation is the lack of an outlet for frustration. In order to address this, it's important to help your employees feel comfortable coming to you with problems.
Resolution of conflict begins with identifying frustrations. Preemptive resolution is identifying what's affecting the practice before adverse consequences result.
In order to help identify these frustrations in your practice, have employees fill out a daily worksheet listing four things:
1. Clarify and verify a policy.
2. Identify a bottleneck.
3. Offer a suggestion.
4. Express a frustration of the day.
This exercise can help team members communicate their issues and keeps management aware that potential problems are cooking.
Management's essential step in the resolution process is to focus on the underlying issue that's causing the conflict. Once you know that certain stress cues are present, ask employees to not only identify the issue but also propose a solution.
Here are some other ways to actively manage conflict in your veterinary practice:
Display a red hook. Near the front door of my clinic hangs a hook made of welded-together horseshoes and painted cherry red. It serves as a reminder that negative conduct in the workplace is "detrimental to the practice's mission" and driven by personal issues, so we make this proposal: "Hang your personal issues on the red hook when you enter in the morning and pick them up on the way home. Do not let them enter the clinic, or you will be sent home."
Improve training. A lot of times, conflict starts with faulty training. Failure to train staff members or monitor their performance, including holding regular reviews, is a common cause of practice conflict.
Provide good leadership. A business is best led by a benevolent dictator. Oppressive practice supervisors and leaders add to practice conflict. So take your cue from a pack of wild dogs that purges its oppressive canine leaders—get rid of tyrannical despots in your veterinary practice.
React and respond. Excitability to flight is a well-known equine trait that horses use to protect themselves; the horse senses something and bolts off to protect itself. This process is called "react and respond." The two actions are instantaneous; a feral horse cannot control the response. "React and respond" is also a common human response to the stress of conflict. Like horses, we cannot control our emotional reaction to a stimulus—a comment or action from another person. However, unlike the horse, we can control our actions when we respond, and practice leaders must respond appropriately.
The best response for effectively resolving a conflict is to engage in positive and nurturing conduct. Or, put more simply, the Germans have a saying that translates to this: "Count to ten. Then respond."