February 2004 Bulletin

Effectively manage your communication style

Tips to deal with workplace stress By Wayne M. Sotile, PhD, and Mary O. Sotile, MA

Have you ever noticed that a thriving medical organization is filled with smiling faces? Research has shown that level of happiness predicts both productivity and health. In prior work, we found that physician happiness cross-correlates with a combination of important organizational and personal factors: health, job satisfaction, work-team cohesion, retention of key employees, quality of marriage and family life, patient satisfaction, patient adherence and malpractice claims.(1)

Protecting physician satisfaction
In today’s changing medical environment, protecting physician satisfaction is a formidable task. More than ever, physicians need to be good corporate citizens—ambassadors of collaboration and collegiality. But between 23 percent and 60 percent of physicians show marked signs of burnout.(2) Also, from training through retirement, physicians report that conflict with peers, patients and the people they supervise is the most significant stressor affecting their personal and professional well being. In fact, only 22 percent of physicians say they received enough training in communication and 40 percent say they received enough training in management skills.(3)

Our work with physicians and medical organizations indicates that the tone of any group hinges on the practice of effective emotional management—the process of managing your own emotions, while also attending to the emotional impact your behavior has on others.

There are six aspects of effective emotional management that can foster individual resilience, collaboration and collegiality.

1. Manage yourself
Your relationships won’t feel any better than you do. The starting point for dealing with workplace stress is to bolster your coping reserves with adequate self-care. It is important that you respect your own mind, body, spirit and personal relationships.

2. Act like a leader
Take the lead in your practice for fostering effective medical leadership behaviors:

• Facilitate interdisciplinary collaboration.
• Speak in terms of “we” rather than “us-and-them.”
• Be a team-builder
• Promote physician involvement by sharing information openly and evenly. Foster group decision-making. Do not participate in gossip. Provide colleagues with honest data.
• Be the first to demonstrate a willingness to change.
• Focus on solutions, not on personalities.
• Confront any behavior that disrupts patient care, organizational operations, collegiality or collaboration.
• Foster optimism and hope about the future.
• Strive to become more business-literate.

Accept the fact that leadership styles must match current organizational needs. Yesterday’s leadership style might need to be replaced by new attitudes and skills.

3. Create team-building contexts Create contexts that give trust, collegiality, mutual respect and teamwork a chance to grow. Meet regularly to discuss organizational issues. Have practice retreats. Set long- and short-term organizational goals, and regularly solicit and give each other feedback relative to these goals. Accept the fact that disagreement between colleagues is inevitable; conflict is optional. How you manage your differences will determine the health or pathology of your organization.

4. Take responsibility for your communication style
Stress tends to make narcissists of us all. Evaluate your communication by the response you are getting. When others’ responses displease you, consider changing your style— rather than blaming them and waiting for them to accommodate you. Avoid using any of the following collegiality-killers:
Silence, bullying, manipulation, ignoring, blaming, mixed messages, snubbing, insults, outbursts, cool/aloof behavior, abruptness, discrediting, secretiveness, passive/aggression, aggression and/or lack of response to input.

Remember: Effective leaders lead with gratitude and make a point to thank others when they are doing things right.

5. Deal with colleagues who demonstrate disruptive behavior
Develop policies and procedures for dealing with inappropriate workplace behavior, including inappropriate displays of anger and any behavior that sabotages collaboration and collegiality.(4)

These guidelines can help when dealing with a colleague who behaves in ways that erode teamwork:

• Strike when the iron is warm, not hot. Don’t wait too long before discussing the issue. Conflict avoidance is one way that medical organizations accumulate team-killing tensions.
• Never blame or shame your colleague, but be clear that the behavior in question is unacceptable.
• Do it in person. Never give negative feedback through a memo or e-mail.
• Do it in private. Never criticize another person in front of staff or peers. If a one-on-one discussion doesn’t work, include colleagues or staff who are willing to join in the confrontation.
• Be specific. Specify exactly which behavior(s) needs to change, and what would work better.
• Do not get into a debate. Behavior that violates your workplace code is simply unacceptable.
• Do not get defensive if counter-attacked. Make it clear that your own behavior is, indeed, a legitimate topic of discussion—in a future conversation.
• If need be, insist that your colleague seek professional help.

6. Try to understand “the other” generation
Today’s medical workplace is diverse in many ways. Managing inter-generational issues is one of the most daunting and important tasks we face in healthcare. Start by understanding the “other” generations.

Older physicians can foster collaboration with younger colleagues by:

• Curbing cynicism about their work ethic, family life or lifestyle. Instead, be inquisitive about what they want.
• Not micromanaging, but mentoring them [younger colleagues].
• Having an open door policy. Invite their opinions and participation. Give crucial organizational information—even if they do not yet get a vote.

Younger physicians can foster collaboration with older colleagues by:

• Showing them respect for contributions prior generations made and for their current plight.
• Seeking their advice and counsel.
• Not assuming that your values differ from theirs.
• Showing up! Accept the compliment of the invitation to be privy to organizational information, to be asked your opinions, and to participate in leadership training.
• Curbing your cynicism about whether or not actively participating in your medical community is important. Collaborative community building will safeguard your future.
• Re-thinking balance. A surgical career will always demand long work hours. Getting family support for your hard work is just as important to staying resilient as is participating in your family life.

Referrences
1. Sotile WM, Sotile MO: The Resilient Physician: Effective Emotional Management for Doctors and Their Organization. Chicago, IL, AMA Press, 2002.

2. Campbell DA Jr, Sonnad SS, Eckhauser FE, Campbell KK, Greenfield LJ: Burnout Among American Surgeons, Surgery, 2001, 130(4): 696-705.

3. Ramirez AJ, Graham J, Richards MA, Cull A, Gregory WM: Mental health of hospital consultants: the effects of stress and satisfaction at work. Lancet 1996;347:724-728.

4. Sotile WM, Sotile MO: Effective emotional management: Managing an inappropriately angry colleague. The Resilient Physician Newsletter, March, 2003;2(2):1,8.