Keeping Arguments and Drama Out of Your Medical Practice

November 7, 2013
Audrey Mclaughlin, RN

It is important for practice leaders to remind physicians and staff that there is a professional way to handle disagreements.

One of my favorite topics in medicine and business is customer service. As you know, I firmly believe that customer service or patient service is the new marketing. 

Without it, your chances of retaining patients and having them refer their family and friends are pretty much zilch. One aspect I would like to cover with you today is what I lovingly call the "family drama effect."

Picture this: You are guest in someone's home for a dinner party. Everything seems to be going smoothly; you and a couple of others are sitting at a long dining table, the host and their family dining with you. The food is served, and the chatter quiets as everyone at the table begins to enjoy their meal.  Out of the corner of your eye, you notice that one of the host's family members gesturing angrily and silently mouthing words to the host. A quick glance at the host shows obvious irritation all over his face. Within a few minutes the host, hostess, and their family members are all in a loud and heated argument in front of you and their guests. Pretty uncomfortable, eh?

Now take that same scenario and place it in a professional environment. Can you imagine being the patient, and having the office manager, tech person, and physician argue over the afternoon schedule in a heated manner while you are sitting in a small exam room? Pretty unbelievable? Has this or something similar happened in your office?

It happened to me two days ago, in the middle of taking my history. I see many uncomfortable situations in the course of what I do on a daily basis, but this last one was impressively uncomfortable, the tension was lasting and palpable. (On a funny note, the look on the physician’s face, when I answered the question "what do you do for a living?" was hilarious.)

I call this the "family drama effect," because for many of us our job is where we spend eight to 12 hours per day. The people we work with are for all intents and purposes our family, and over time it can become one big dysfunctional and loving unit. It is important for the leaders in a work family to remind the group that there is a professional way to handle disagreements. 

It is imperative that these disagreements remain private and that there is a code of conduct professional conduct in front of patients. Not only is airing your grievances poor customer service, but luckily for that office I didn’t leave and immediately post to Facebook or Twitter about the issue. Who is to say that the people in the exam rooms on either side of me didn't, or the patients in the waiting room didn't when this disagreement was carried to the reception desk?

Here are five simple and easy-to-implement steps to get you on your way to reducing or removing the "family drama effect":

1. Start with yourself. As a leader in your medical practice, start with yourself in avoiding the family drama effect. Be honest with yourself about your culpability in the culture of the practice.

2. Investigate and diagnose the issues. Find out the details in the most professional manner possible. Diagnosis can be difficult, sometimes it is a matter of one employee says versus another. Try to cut off issues before they become dramatic.

3. Handle any issues as quickly as possible. Drama breeds more drama. I like to ask any employees that have been arguing with each other to write down 10 good qualities about each other and discuss them.

4. Have regular staff meetings. Include in your staff meetings reminders of what professional behavior is expected of them. Also review what to do when there is a disagreement. Be sure and include fun team-building exercises.

5. Halt the office rumor mill. Many times after a dramatic event between staff members the rumor mill is churning out gossip. Remind your staff of the office's "no gossip" policy (if you don’t have one, get one).

Remember to keep the family drama away from patients and guests. It is a terrible feeling to be the innocent party in the room of drama, especially when you are expecting professional behavior. Not only that, it is a fast way to chase away your patients and earn a poor reputation in your community.