Confront the elephant


Are there tough talks you're not having? Learn to lay issues on the table and push that pachyderm out of your practice and your life.

Hem and haw, dance around the issues all you like, but first acknowledge this simple truth: Practices derail when people don't say what they're thinking. So ask yourself how often you say things you don't mean. "I'm fine." "No, that didn't bother me." How many meetings have you attended where the real issues weren't being discussed? These are signals your team needs to have more fierce conversations.

So what is a fierce conversation? Think passion, integrity, authenticity, collaboration—think practice or cultural transformation. Sounds pretty good, doesn't it? And amazingly, the right conversations can help you get there.

Where are you today?

Take a few minutes to evaluate where you are. Practices that successfully tackle fierce conversations can focus on results. These teams agree on goals and priorities, and they collaborate and execute change. When fierce conversations don't happen, the team's focus shifts to activities. Initiatives stall, and there's an "us versus them" or "me versus you" culture.

Here's a quick look at the four types of fierce conversations:

1. Team conversations. These are frictionless debates that interrogate reality and ignite dialogue around clarifying goals, solving problems, and evaluating opportunities. The result: impeccably executed decisions for the practice. For example, "This March, we're going to focus on presenting estimates for dental exams. Our goal is to increase dental exam compliance by 15 percent."

2. Coaching conversations. Fierce coaching conversations engage people to increase clarity. They improve understanding, provide impetus for change, and encourage professional development, project advancement, and accelerated results. These conversations address positive or negative behavior. Tell the team member what he or she did, offer your response, and explain how the behavior affects the business. For example, "You arrived late today. That frustrates me because when you're late, the team can't complete necessary tasks before appointments begin." Coaching conversations are successful when employees take responsibility for their job performance.

3. Delegation conversations. These conversations assign and clarify responsibilities and raise the level of personal accountability. If you're the delegator, explain team members' new responsibilities and how you'll measure their performance, then create an action plan. For example, you might say, "Inventory is now the team's responsibility, because we all need to help manage drug and supply costs to control them. Here are your individual responsibilities."

Fig. 1

Then you're freed to assume more complex decisions. For every task, ask yourself, "Who can assume this task and free me to accomplish something no one else can?" If you're the team member who receives the extra responsibility, this opens a new path for growth.

4. Confrontation conversations. These discussions engage people to successfully resolve attitudinal, behavioral, and performance issues. We name and address tough challenges, we provoke learning, and we enrich relationships.

If you're a manager, you might initiate this conversation when you notice unacceptable behavior. "I witnessed your conversation with Sarah. I observed you rolling your eyes. Is that the message you wanted to send?" Then the team member should acknowledge her behavior. If she doesn't, you'll say, "Maybe you didn't intend to be rude, but that's the message you sent. Your behavior isn't in line with our practice's core values. If it occurs again, you'll face the consequences outlined in the employee handbook."

Fig. 2

The rules for fierce conversations

Your goal is to get fierce—to interrogate reality and get issues on the table. So write a press release for what's going on in your practice and your life. Ask, who, what, and where is the problem, and when and why does it happen? Follow this advice to get real:

  • Avoid laying blame. Start by substituting the word "and" for the word "but." "But" is a way of avoiding and blaming. "And" is a way of investigating and accepting.

  • Uncover the ground truth. The official truth: Your goal is to be the gold standard for veterinary practices. The ground truth: You're embarrassed by your sloppy reception area and long wait times. You discover the ground truth by asking yourself and your team members, "What changed since we last met? Where are we succeeding and failing? What have we learned and what's required of us now?"

  • Examine your personal integrity. Look at your core values. Are your values and behavior out of alignment in your workplace? What will you do to fix the discrepancy, and when?

  • Create a vision for your life. Ask yourself, what's my ideal relationship with each of my co-workers? With each client? What contribution do I ultimately want to give to my family, community, and society?

Get ready, get set, get fierce

What fierce conversations are you avoiding? Use these seven steps to uncover the discussions that will change your life:

1. Identify the issue. Ask yourself, what conversation or issue am I avoiding? What instinctive responses am I ignoring? Who would benefit from my undivided attention—perhaps myself? To whom do I need to apologize? Who deserves my praise? Where and with whom am I failing to be authentic?

2. Clarify it. What's going on? For how long? How bad is the situation?

Fig. 3

3. Understand the effect. What results does the situation produce? When I consider how the situation affects myself and others, how do I feel?

4. Determine future implications. If nothing changes, what's going to happen? What's at stake for me or my team?

Fig. 4

5. Know your part. How have I contributed to the problem? Did I cancel a meeting date and give the impression I don't care? Did I raise my voice to a co-worker and now I should apologize? Did I communicate clearly?

6. Describe the ideal outcome. When the issue is resolved, what difference will it make? What results will others enjoy? When I imagine the resolution, how do I feel?

7. Commit to action. What's the most potent step I can take to create resolution? What might get in the way, and how will I get past it? When will I take this step?

Fig. 5

When communication is the only solution

If you don't tackle the real issues or your conversations don't change the outcome, what are the implications for your career and life? If your work situation is exactly the same five years from now, what's the emotional, spiritual, and economic price you'll pay?

Poet David Whyte says, "No one has to change, but everyone must have the conversation." Often we find out—even if we want to be isolated—we can't get where we're going without family, friends, or co-workers, and we must have fierce conversations along the way.

Shawn McVey, MA, MSW, is a Firstline Editorial Advisory Board member and CEO of Innovative Veterinary Management Solutions in Phoenix. He lectures 50 times a year, which includes the Veterinary Economics Managers' Retreat April 17, 2008 in Baltimore. Please send questions or comments to

Shawn McVey

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