Conflict closed this practice's doors for good. Don't suffer the same fate.
Meet Drs. Andy and Ben. (these aren't their real names, but this is their real story.) They're long-time friends, classmates, who want to start a practice together. They appreciate each other's skills and believe they'll work well together as business partners.
Dr. Andy is methodical, organized, and focused on getting things done. Dr. Ben is a creative thinker and a visionary, always looking ahead for new opportunities. So Drs. Andy and Ben embark on a journey together. They purchase land, build a facility, and hire staff members. They're about to live their dream.
But it wasn't a dream at all. Their practice turned into a nightmare. Two years later, Dr. Ben calls me. "Things aren't going well," he says. "Dr. Andy and I just don't see eye to eye. I want out of the practice. Can you help me?"
I wish I could tell you their story has a happy ending. It doesn't. The truth is I couldn't help. Their conflict had turned the practice on end, resulting in severe turnover and a declining client base. Both doctors had considered filing bankruptcy because they couldn't cover their mortgage payments on the practice property. They ultimately went their own ways. How could conflict get so bad that it literally tears a practice apart?
Drs. Andy and Ben let their differences generate conflict from Day 1, and they did nothing to stop it. Of course, not every disagreement results in conflict. In fact, most disagreements are constructive. They're a natural part of interacting with others and serve as a catalyst for positive change. What differentiates disagreements from conflict is how the participants choose to deal with them.
Drs. Andy and Ben chose not to deal with disagreements at all. Dr. Andy says that Dr. Ben always wanted everything to be nice and pleasant and for everyone to be happy. "He wouldn't talk about our problem," he says. "He thought it would go away by itself."
Meanwhile, Dr. Ben says confrontation made Dr. Andy uncomfortable. "As a result, our differences took on a life of their own, killing our practice," he says.
What started as complementary strengths surfaced as differences in the doctors' working styles, and unaddressed, they led to disagreements. These disagreements led to conflict for several reasons:
The owners' behaviors also caused business problems. Their relationship with each other, their staff, and their clients suffered, resulting in costly mistakes and delays. Everyone spent time dealing with stress and anger. Everyone's productivity dropped.
In my consulting work, I often see the results of unresolved conflict. The emotional energy required to suppress conflict takes time, effort, and compassion away from clients and patients. So the effects of the conflict reach beyond those directly involved.
For example, two doctors operating in conflict mode who can't agree on standards of care, such as when they'll require preanesthetic lab work or when they'll recommend six-month exams instead of one-year exams, can be divisive at the staff level. Who's lead does the team follow?
When callers ask about a practice's vaccination protocol, I've heard receptionists say, "It depends who your doctor is." And if there are six veterinarians in your practice operating in conflict mode, your receptionist must learn six answers to every client question. Staff members no longer know the definitive answer and they start questioning everything.
Our code of conduct guides the way
The symptoms of unresolved conflict don't stop with poor recommendations. Consider these other ramifications:
Of course, conflicts engender some unquantifiable costs—the emotional toll on you and your family and the loss of friendships, for example. There's no easy way to figure these costs, though they can be high. Direct costs of such conflict include fees paid to mediators, attorneys, or other professionals. And you need to consider productivity costs, including lost time and inefficiencies.
Out of control? Take swift action
How many hours per week do you spend on conflict in your practice, and what's the price tag? That's exactly what Dr. Andy wanted to find out. Here's what he looked at:
For example, Dr. Andy asked his favorite technician to research a software system that he wanted to buy. The technician's recommendation resulted in a purchase. Meanwhile, a technician loyal to Dr. Ben knew from experience at a prior practice that the software wouldn't meet the practice's needs but didn't share her knowledge. After the software was installed, Dr. Andy found that it didn't suit the practice. Six months later, they replaced the system at a cost of $18,000.
There was an added loss, too. Keeping two very talented technicians away from each other reduced opportunities for collaborative problem solving and creativity, which could make the difference in saving a patient's life.
When Dr. Andy tallied all these costs up per year, he reached about $146,000. The practice was spending almost as much on conflict as it was on the doctors' salaries. And that's not everything. Dr. Andy could have continued to add in costs from absenteeism, health issues, and even employee theft that could be traced back to their unresolved disagreements.
Drs. Ben and Andy had a choice, though. They could have stopped the downward spiral that conflict was causing in their practice. While it's too late for them now, it's not for you. If you know you've got conflicts to resolve, start by identifying the source. You'll likely find that it started when:
Adding up the costs
Protocols for harmony
Jim Collins, the author of Good to Great: Why Some Companies Make the Leap ... and Others Don't (Collins, 2001), talks about this concept in terms of getting the right people on the bus. If you have talented people on the bus who believe in your culture and philosophy of medicine—your practice—and you have the wrong people off the bus, then you can take the bus someplace great. And you can change directions as needed to adapt to your changing world.
When you see these situations crop up in your practice, stamp them out immediately. To help get back on track and to prevent future problems, consider instituting a framework—I like to call them "Protocols for Harmony"—for addressing differences that arise.
As I mentioned, the conflict between Drs. Andy and Ben had gone too far. Unfortunately, the cost turned out to be unaffordable. The owners split and moved to different parts of the state. Today, they are sole owners of their own practices. They have no contact with each other. And they've lost a friendship that was important to them.
I hope you never experience a similar situation, especially considering how avoidable it is. Remember, most disagreements are constructive—they serve as a catalyst to positive change. When disagreements are addressed, they bring everyone's attention back to the practice's purpose, putting everyone back on track with renewed enthusiasm. Think of disagreements as an opportunity for learning and personal growth. Is your practice prepared for the opportunities that are coming its way?
Veterinary Economics' Financial Editor Cynthia R. Wutchiett, CPA, is president and co-owner of Wutchiett Tumblin and Associates in Columbus, Ohio. Please send questions or comments to: firstname.lastname@example.org