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In 2020 alone, The Dentists Insurance Company’s Risk Management Advice Line received 18,018 calls from dentists seeking support to navigate practice challenges. It’s a number that illustrates the myriad conflicts dentists navigate today as well as the profound need for tools to help them expertly de-escalate potential crises.
Through the Advice Line, experienced analysts provide guidance to TDIC policyholders and members of dental associations in the states the insurance company serves — consulting on everything from COVID-19 pressures to employment concerns to problematic patient situations. Regardless of the topic, a common theme across the thousands of calls is a lack of confidence or comfortability in resolving conflicts. In fact, dentists sometimes ask the Risk Management analyst if they would be willing to speak to a patient or employee on their behalf. However, it’s the analyst’s role to provide the education, support and preventive advice to empower the dentist to independently engage in those conversations.
The ability to resolve conflicts comes more naturally for some than for others, but many people avoid, delay or, at the very least, greatly dislike disagreements.
What’s keeping you from conflict resolution?
The pull of procrastination
When we hold the false premise that all conflict is bad, of course we want to avoid it. However, the absence of conflict isn’t harmony, it’s apathy. When patients or staff speak their minds, it’s usually because they care. As Advice Line calls, claims and cases illustrate, avoiding conflict only allows the conflict to grow. We must understand that conflict will not resolve on its own.
“Non-procrastinators focus on the task that needs to be done,” volitional psychologist Joseph Ferrari, PhD, explained in an interview with the American Psychological Association. “They have a stronger personal identity and are less concerned about what psychologists call ‘social esteem’ — how others like us — as opposed to self-esteem, which is how we feel about ourselves.”
The aspiration to be agreeable
It’s natural to want to be nice and kind, especially when sustaining relationships with staff and patients over many years. However, a dentist or office manager will often support an agreement or compromise that is not in the practice’s best interest, simply to preserve their likeability. When approaching a situation with an intention of a resolution, rather than a win, it’s possible to disagree without being disagreeable. As author Max Lucado said, “Conflict is inevitable. Combat is optional.”
The lack of psychological safety
Trusting relationships among practice teams and between practices and their patients are built over time. Have you fostered an environment where staff can disagree without fear of hostility or being seen as disloyal? High-performing teams provide channels for feedback, encourage conversation, value reliability and hold each other accountable.
The tendency to take things personally
In the heat of conflict, we can be so busy disliking each other that there’s no energy left for productive debates. The truth is that when a personal conflict exists, every conflict large and small is seen in a negative light. Evaluate conflicts with objectivity: Is the issue centered around a task or issue, a pattern of behavior or truly the relationship? When every issue is interpreted as personal, our egos and esteem affect our ability to successfully resolve them.
Strive for these five principles to mitigate and de-escalate conflict:
Overgeneralization can increase drama. For example, “You’re always late to work,” is a broad statement that invites defensiveness. “I’m concerned that you’ve been about 30 minutes late the past three Fridays” is a specific, facts-based example. Alternately, to preserve likeability, communications may be so vague that both sides are left with different interpretations. If the dentist remarks on the employee’s lateness, even if there’s no specificity or follow through, the dentist may feel like they’ve addressed the issue and the employee may feel like they’re off the hook. This lack of clarity means a conflict is likely to occur in the future if the employee is late again.
With patients, clarity comes with listening to concerns firsthand, not deflecting issues or delegating them to staff. Patients, just like everyone else, want to feel heard. Allow them to voice their concerns without interrupting or speculating on what may be driving the issue. Listen attentively to the patient and then repeat back your understanding of their concern so there is no misunderstanding about the source of conflict.
Whether at home, in the practice or out in the world, we tend to judge others by their actions and ourselves by our intentions. Others do the same. In the case of an employee who is late to work, the dentist judges the action and the impact to the schedule. The employee judges their own intentions and everything they’ve done — fighting traffic, getting kids to school, skipping breakfast — to try to make it to work on time. While the intention doesn’t excuse the action, an attempt to see both sides will facilitate more productive, solution-oriented discussions. Empathy also extends to saying thanks to employees for positive contributions of every size and offering sincere apologies when you’re in the wrong.
Living with unresolved conflict can be stressful but rushing to a solution rarely bears long-term gain. When a patient or employee has made a demand or offered a solution that you may not be able to accept in its current form, explain that you will need time to consider their request and return your decision.
Understand that the individual with whom you’re working through the conflict may also need time to consider their answer to your proposed solution. However, if a patient’s demand is unreasonable, such as never scheduling a specific staff member on the day that they come in for their appointments or demanding exorbitant compensation, it is fair to answer at the time. Give a measured response that keeps the discussion open to reasonable demands, such as, “I understand that you are unhappy, but I don’t feel that your request is truly a fair assessment of the events,” or “I don’t feel it’s reasonable to ask me to make adjustments that would create a disruption for my practice as well as other employees or patients.”
Easier said than done, isn’t it? How the message is being delivered and who it is delivered by often determines how we’ll engage more than the content. Taking a calm, respectful approach and, if needed, finding a private place to talk helps create the space for an objective discussion. When struggling to approach or engage in a conflict, start with the facts. No need to disparage others’ character or values or to bring up past conflicts unless there is an established pattern of issues. View the situation as an opportunity to analyze the point of conflict, share your observations and listen to the other perspective before pursuing a resolution.
Empathy doesn’t mean making assumptions about others’ experiences. Listen first, engaging the patient or employee with questions to understand their perspective. Your curiosity can help de-escalate rapid escalation of conflict. For the late employee, an approach could be, “I’ve observed that you’re on time for most of your shifts, but not for the last few Fridays. Is there something going on that day that we can talk about?” Once you’ve heard the employee’s side, invite their input in finding a solution.
Conflicts in the dental practice are inevitable, and the pressures of the past year have amplified disagreements in financial, scheduling, employment, clinical protocol and health issues. By addressing conflicts early and reframing them as an opportunity to productively address unresolved issues, you can better protect your practice.
TDIC’s Risk Management Advice Line is a benefit of CDA membership. Schedule a consultation with an experienced risk management analyst or call 800.733.0633. Reprinted with permission from the April issue of the CDA Journal.