Straighten out convoluted conversations in your practice

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Don't be put in the middle. Teach team members to communicate with each other.

You aren't a traffic cop. You're not a referee or a nursery school teacher. But there may be times at your practice when you feel like you're all of these things and more, especially if team members constantly come to you to solve their problems with their peers. Whether it's an associate and a technician who engage in character assassination behind each other's backs or a couple of receptionists whose squabbles create a frosty front desk atmosphere, this behavior has to end. And it can end in one of two ways: team members learn to communicate or they move on.

Unfortunately, in many practices the approach involves you—the doctor or the manager—sitting down with the warring parties and playing parent to a couple of adults who act more like siblings than coworkers. Let's talk about what triangulated conversations are and how to halt them in your practice.

INTENSE CONVERSATIONS

To tackle tough conversations in practice, you need to get intense.* Intense conversations are those in which you come out from behind your "nice person" (read: "conflict-averse") facade and make the discussion real. The goal of an intense conversation is to get reality on the table where you can deal with it, and these conversations are marked by passion, authenticity, and integrity. Talk may be cheap, but avoiding a real conversation costs you more in the end.

Let's get this straight: Intense conversations do not involve attacking another person or destroying his or her self-esteem. You engage others in intense conversations to make things more clear and provide the psychological impetus for change.

Business is basically an ongoing conversation. And if you refuse to confront issues as they arise in that conversation, you shouldn't be managing a veterinary practice. But keep in mind that these skills can be learned—they don't come naturally to many people, especially in the veterinary profession. Even the meekest person can become a black-belt conversationalist with the determination and willingness to learn. After all, confrontation doesn't mean war. It means stating what you need and what you want and resolving differences with other people.

To get started, let's look at four different models of conversation that must be the go-to tools for your practice. They are:

1. Group conversations. In these discussions, two employees examine a situation without either one having a meltdown. This conversation should be frictionless—for example, a receptionist and a technician talk about a disagreement without laying blame, getting personal, or becoming emotional. Encourage employees to engage in these conversations on their own.

2. Behavior-related coaching conversations. Your goal in a coaching conversation is to improve a team member's understanding of his or her own behavior and motivate that person to change. In coaching conversations, you look to improve professional development, advance projects, or accelerate results.

3. Delegation conversations. In these conversations, you add to a team member's responsibilities and raise the level of his or her personal accountability. As a manager, you should always be looking for ways to push decision-making down to the lowest possible level, so you should be having these conversations frequently.

4. Clarifying conversations. While you need to put up with an employee's personality at work, no matter what it is, you don't have to put up with behavior. So when behavior becomes an issue, you engage the team member to successfully resolve the problem. Clarifying conversations focus on attitude, performance, or personal conduct. Your goals are to name and address the top challenges, provoke learning, and enrich the relationship. (It's true! Haven't you experienced a deeper connection with someone after he or she called you on your crap? Healthy confrontation is a relationship builder.)

*The author acknowledges Susan Scott and her book Fierce Conversations: Achieving Success at Work and in Life One Conversation at a Time as the source of many of the ideas in this article.

RULES OF ENGAGEMENT

Now that we have a framework for how intense conversations can help you in practice, let's look more closely at triangulated conversations. A triangulated conversation occurs when Person A experiences a problem with Person B, but instead of addressing the issue directly with Person B, Person A talks to Person C. And you guessed it: Person C is often you. In many veterinary practices, team members refuse to manage themselves. They vent to their managers and talk about their peers to others but never confront one another face to face. And managers often overcompensate by intervening, which creates more problems than it solves—including promoting a culture of gossip.

The truth is that you can't manage behavior you haven't witnessed. So in cases of "he said, she said," you need to push your team members to talk with each other directly (see "7 steps to intense conversations" below). If you didn't see someone do something, don't offer feedback about it. You should step in only if communication between the people in conflict breaks down. When this happens, your goal is to help both parties communicate and resolve the issue together.

Let's say Ann thinks Doug is a problem. But Ann doesn't want to talk to Doug. So instead she rats him out to Nora, the practice manager. This is completely inappropriate. (In fact, if I were managing this hospital, I'd write Ann up for insubordination because I have a zero-tolerance policy for triangulated conversations in the workplace.) If Ann is too afraid to confront Doug, she needs to learn to live with Doug's behavior. What Ann has decided is that she doesn't want to take responsibility for confronting Doug. She wants Nora to do all the hard work.

Instead, Ann should say, "Doug, I'm having real difficulties with how you're speaking to me right now, and I'd like to talk about it."

Now it's likely that Doug will respond by saying something like, "I haven't done anything wrong. You just need to get over yourself. You're too sensitive," then turn and walk away. If this happens, Ann needs to have enough chutzpa to say, "Wait, we're not done here. If you won't have this conversation with me, I'm going to talk to Nora about it. And you'll need to come talk about it with me, because I'm not letting this go."

So later, when manager Nora taps Doug on the shoulder and says, "Doug, we need to talk," Doug knows he's not going into Nora's office to defend himself against Ann's accusations. Rather, he must answer for his refusal to talk to Ann when she approached him to resolve the issue.

From Nora's perspective, the problem is that Ann and Doug aren't talking. And this is a problem that you as a manager can address. The bigger problem develops when two employees can't resolve their issues. If you haven't witnessed the behavior, you can't manage it. But you can be a mediator and help the team members get to the rub of the issue. At the very least you can teach the two employees that they must talk to each other.

In many cases, your problem employees will eventually grow tired of being confronted or pulled into your office to have this conversation over and over. That's when they'll get off the bus and exit your practice.

Once you've eliminated triangulated communication at your practice, the results can be life-changing. As a manager you'll find that 90 percent of the time you used to spend coaching employees will just go away. You'll realize that you weren't coaching them at all—you were enabling them and allowing them to vent so they could be toxic to others.

TOUGH TALK

If you employ team members who don't know how to communicate, one of your goals should be communication training. You can achieve this in many ways. For example, you might bring in an outside expert. Every town has a community college where somebody teaches Communication Skills 101. Hire this person to come to your practice and teach your team.

Next, make intense communication a team exercise. Get your employees together in a room and organize them like a college debate team. Point out that during a formal debate, people don't scream at one another. They don't yell at all. They contain their emotions. They engage in point and counterpoint. Come up with a hypothetical but true-to-life clinic scenario, then have the two teams take opposing viewpoints and discuss the issues with civility and respect. For example, a manager and an employee need to change a shift or schedule. How do they negotiate that? Your job is to coach the two teams so that they function similarly when they address problems with each other.

Now let's talk about a common problem in veterinary practices: crying. Many team members start to cry when you initiate an intense conversation. In psychological terms we call that "decompensating." How do you manage it? You don't. You tell employees you'll discuss the problem behavior when they're under control emotionally (and if they can't regain control, they need to go home for the day). If you do this enough times—and team members learn they can't make the conversation go away by decompensating—eventually most will be able to discuss the issue calmly. If they can't ever get to that point, they're not fit for the workplace.

Here's another rampant issue: Many practice owners and managers make exceptions for toxic employees because their technical skills are so strong. In fact, the most gifted person on your team—the most competent technician, skilled doctor, or multitasking receptionist—is often the most difficult. Know why that is? Because this difficult person runs off other could-be-talented employees before they have a chance to develop their skills. The people who stick around are the beaten-down, easily cowed team members who put up with being told how and what to do all the time. That doesn't make much sense, does it?

When people are toxic to the work environment, get them off the team. Don't hold onto a difficult employee because you're afraid you won't survive without her skills. You will. You can't function in an environment where people won't talk openly and respectfully to each another or, worse, who engage in personal sabotage of their coworkers.

A cornerstone of a well-run practice is a team where people speak directly and calmly to each other about problems. So it's your goal to train your whole team to communicate more effectively—from kennel attendant to practice owner. Good communication is key to your practice's future and its success.

Shawn McVey, MA, MSW, is CEO of Innovative Veterinary Management Solutions in Phoenix and a Veterinary Economics Editorial Advisory Board member. Post your comments on the dvm360.com/Community message boards (see the "Comment on articles" board), or send an e-mail to ve@advanstar.com

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