Want a less stressful life? (Tough conversations made easy!)

Is there a situation in your life that drives you crazy?
An employee who continues to do a poor job?
A child, relative, or friend who acts in a way you have asked them to stop?
A work or home environment that encourages poor behavior or that creates unnecessary tension or animosity?

We frequently obsess over these challenging situations and believe they will never change. We withdraw from even considering a conversation to address it, as we already have a list of reasons why it won’t work. (In fact, we rarely know for certain what the outcome of any interaction will be.) Instead, we prefer to suffer with our dissatisfaction. And that diverts precious time and energy from our already busy lives.

What if holding these conversations were easy?

Disclosure: Many years ago, I allowed an incompetent employee to remain in my practice for four years. While I was paralyzed by my concern for her and her family’s financial welfare, afraid that I wouldn’t find someone to take her place, and handicapped by a lack of skill in communication, she and I were burdened with the awareness of her inaccuracies, the morale in the office was negatively affected, and I became increasingly frustrated and irritable. In the end, I abruptly let her go when her lack of expertise became a liability. Fast forward a few years and a lot of communication training and I can see how easily this situation might have been addressed – honest!

Before holding a difficult conversation, it’s important, as the people at VitalSmarts recommend, to “start with your heart.” Ask yourself, what do I want for the other person? For our relationship? For the organization? For me? Armed with the answers to these questions, you can then construct an entry and a conversation to address the situation.

If the situation involves an employee who performs poorly, you might decide that you want the person to become more competent so that s/he feels more confident and happier about his/her work. You might realize that the relationship is becoming strained because your requests for certain changes have been met with no significant action, and you would prefer to believe the person to be trustworthy and committed to the practice. It’s likely that the organization would benefit from an improvement in this person’s performance. And you certainly would like to remove this worry from your life.

Given this set of answers to the questions, you might begin by informing your employee that you would like to have a conversation and asking if this is a good time. Explaining that you have concerns about his/her job performance and how it’s affecting him/her, your relationship and the practice would be a good introduction. Then, you can follow these simple steps:
1. Be very specific about the overall behavior and the instances in which it was manifested. Generalizations such as “you’re rude,” or “you seem unmotivated” don’t convey enough specific information to allow the person to understand the issues or to change.
2. Review your motivations and concerns (the answers to your questions) so the person can see the consequences of their behavior and the importance of change.
3. Again, be specific about what changes you are requesting and what that will look like. 4. Ask the person if they feel there are any obstacles to this change.
5. Inquire how you might support them in making the changes – do they need additional training or mentoring?
6. Finally, inform them when you will expect the changes to be made – by the end of the day? Within 2 weeks? Over the next 2 months?

I can imagine that some people might think, “I could never hold a conversation like that – it sounds too uncomfortable!” So I’d like to let you in on a little secret – no one likes to have these conversations. But if you are clear about why you want the change – what you want for you, your relationship, the organization and the other person – you will see that you are performing a kind and generous gesture in the service of greater satisfaction for everyone involved. And you won’t believe how easy it was!

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About Helane Fronek

Over the past 28 years I have had a fascinating and fulfilling career in medicine, initially practicing as a general internist and then as a procedural specialist, caring for patients with vein disorders. As Assistant Clinical Professor of Medicine at UC- San Diego School of Medicine, I’m thrilled to be teaching medical students crucial communication skills along with many other aspects involved in the practice of medicine.
This entry was posted in building relationship with patients, effective communication in healthcare, honesty in medical care, physician coaching, physician communication, physician fulfillment, physician work life balance and tagged , . Bookmark the permalink.

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