Staff Management

Boost Efficency with a System for Conflict Resolution

By Thuy-Lan Nguyen, OD

June 15, 2016


Employee conflicts are costly to your practice. They lessen efficiency and compromise the high level of service that promotes patient loyalty. Develop protocols to resolve conflicts and improve office processes.


SET UP A SYSTEM. Conflicts are inevitable, but handling them with a system can resolve them fairly and produce process improvements.

KEEP COMMUNICATIONS OPEN. Make discussion of conflicts and differences a regular part of staff meetings

SEE THE UPSIDE. Channel disputes toward positive change in inter-staff communications.

When people spend 30+ hours a week together–more time than most people spend with their families–disputes are bound to arise. I’ve learned during my 14 years in practice to spot brewing problems between employees, and to helpsmooth out conflict when it occurs.

Conflict is inevitable, and when it’s played out in front of patients, it can be deadly to a practice. For that reason, my practice has a systematic approach to handling conflict.

When dealt with systematically and professionally, conflict can lead to healthy outcomes. Conflict can be a good opportunity for employees to display leadership skills and build trusting relationships. Over the years, I have seen some employees handle conflict very well. Often, those valued employees made me aware of problems I didn’t even know about. Leaders embrace solutions, not excuses. The employees that I value the most are the ones who acknowledge a problem, but are also ready to discuss changes and solutions, instead of just dwelling on the problem itself.

Regular Office Meetings Deter Conflict

Regular office meetings and team-building activities can help create an office environment where disputes are less likely. Typical office meetings that establish, or remind, employees of office policy sounds very basic. But conflict is less likely to occur if everyone understands office policy well. I find role playing to be a useful tool during meetings. For example, if you discover that your office has a problem with an employee constantly coming in late, or wandering away from their station, have a meeting where one person sits alone at the front desk and then ask every other employee to use their cell phone to call the office at the same time. Then ask another person to pretend to be a patient coming in for their scheduled appointment. When all the phone lines light up, and one person tries to handle the phones and the patients alone, everyone can see how stressful it is.

Conflict Takes Many Forms in an Office

I was in large practices with over 30 employees for 10 years, and now I’m in a smaller practice with only five employees. Practices of all sizes may see conflict between staff members.

Most office disputes involve two or more employees that want to accomplish a task, but disagree about how it should be done. They disagree about the process. Other types of disputes involve one employee feeling that another employee is acting inappropriately or not pulling their weight. And even the most productive employees can have personal conflicts with their co-workers.

For example, Employee A is casually talking to a patient about their new glasses. Employee Z is filing an insurance claim online for another patient. Then the phone rings. Which employee should answer the phone? Employee A argues that talking to a patient in the office is more important than filing an online claim, so Z should answer the phone. Employee Z argues that filing the claim online is very complex, and if they don’t focus on the details, an error could cause the claim to be paid incorrectly or even denied, so A should answer the phone. Each employee claims the other is not being a team player.

The heart of the problem is that each employee cares about doing their job well, but thinks the other is wrong. Trivial disputes such as these may seem insignificant in the grand scheme of things. However, resentment between A and Z can continue until both employees start nitpicking on each other. Before you know it, both are unhappy and it affects everyone’s day-to-day functioning. Then, eventually, patient care suffers.

Leave Both Sides of Dispute Feeling Respected

The best way to calm these common contentious situations is to ensure that each team member feels respected and understood. The goal is to resolve the conflict, but in a way that all parties feel that their side was acknowledged. A practice leader’s priority is to remember that the heart of the conflict is that each employee cares about the office, and they are each trying to do the best thing, even if they disagree. Remind each employee that relationships are the priority, and to treat each other with respect. Separate the people from the problems. Focus on the issue without damaging the relationship. In the earlier example, remind both employee A and Z that both are capable of multi-tasking when necessary. Employee A can politely excuse themselves from the patient to answer the phone. Employee Z can also save their information, answer the phone and then return to the claim.

This type of exercise can allow you to then set up a system in which it is understood that if one employee isn’t able to answer the phone, then another designated employee should answer it, and if that employee isn’t able to answer, then a third designated employee should step in.

Have Employees Share Information & Work Together on Conflict Resolution

Building an environment where every team member feels respected is the key to preventing common disputes in the first place. While there is always a hierarchy of employees based on seniority and responsibility, each employee from the optician with 20 years of experience, to the new receptionist, should actively participate in sharing information and helping co-workers solve problems. Practice leaders should routinely observe day-to-day activities and acknowledge successful teamwork when it occurs.

For example, if an employee is able to regularly manage a patient, and also help a patient on the phone at the same time, they should be acknowledged. They are taking care of patients properly, and setting a good example for others to follow. They should be thanked for doing their job well. Once people start to respond to workplace challenges differently, there is a greater chance of other things changing, too.

Identify Neutral Mediator

Once a legitimate dispute among support staff occurs, a neutral party must be involved. This is typically the office manager or human resources manager. Conflicts should be managed away from any areas where patients may be. No patient should hear, or witness, workplace disputes. It may even be necessary to take things out of the office. Take the staff out to lunch to hash out the problem. Employees may be more relaxed and willing to compromise when they are temporarily removed from the environment they find contentious.

Most practices have a designated office manager to manage day-to-day disputes. Some large practices not only have an office manager, but also have an HR manager to mediate employee complaints. But if you are the owner and doctor of a smaller practice, you may be all of those things on your own.

The challenge for many small practices is when the doctor wears many hats. Often, the doctor is also the owner, the office manager, HR specialist and mediator. Many doctors may stand on the sidelines during workplace disputes. But ignoring them may have a bigger impact in the long run. As a manager, conflict resolution is part of the job description. And if a doctor chooses to be their own office manager, they should be prepared to handle some disputes personally.

TellEmployees to Handle Personal Life Conflicts Outside Office

When staff members argue about personal conflicts–things that have nothing to do with the workplace–then the doctor, or office manager, may want to step back and tell them to find a resolution on their own. They should know that if personal problems interfere with their job performance, they both may be terminated. For example, two employees become friendly with each other outside of the office. They have mutual interests, and begin doing things together after hours. During a friendly dinner, they argue about the bill. The next day, both are distracted and acting unprofessionally toward each other. When this happened in my practice, I sent both employees home early and told them to cool off and come back when they could put their personal differences aside and act professionally, or not to come back at all. Those two employees were never friendly outside of work again, but they managed to not let it affect their job performance.

Enact Policy: No Romantic Relationships Among Employees

Another possible source of employee conflict is when a romantic relationship between two employees ends, and in-office problems typically begin. I learned this lesson the hard way. I did not have a policy forbidding intra-office dating until it was too late. In the best case scenario, if you have set rules about intra-office dating, and two employees choose to date anyway, they know they are breaking the rules, and that their job could be in jeopardy. Therefore, they are more careful not to let the relationship affect their performance at work.

And if their relationship gets serious, they are more likely to come up with an amicable solution on their own. One employee will most likely look for another job if their relationship is more important to them. However, if an office does not have a policy against intra-office dating, then a romantic relationship between two employees is more likely to cause problems at work. If and when that relationship affects their performance at work, it is more challenging for a manager to resolve the conflict. There is no easy solution. There is no right or wrong answer, since management did not establish a policy in advance. This is the worst case scenario. Therefore, I would recommend creating a policy as soon as possible and informing all employees immediately before it’s too late.

Call in Outside Expert When Necessary

If a conflict among a few individuals cannot be resolved, or when it affects the entire office’s morale significantly, a practice may need to call on an outside expert for a solution. If the general attitude of all the employees is negative because of a specific office policy, a third party may need to handle questions and complaints. For example, when my office had to make a change on employee benefits due to the increasing cost of medical insurance coverage for the business, almost all the employees protested because their premiums increased. A few threatened to leave. Luckily, the payroll company that facilitated the employee benefits sent out a human resources generalist (HRG) to review why the changes needed to be implemented, what the specifics of the changes were, and the impact on each employee. After that office meeting, the employees were informed and felt reassured.

Don’t Allow Employees to Give Ultimatums

Hopefully it never happens to any of us, but if two high-performing staff members have a serious dispute, and one of them says “it’s either them or me,” a practice manager has a tough decision to make. Do you risk loosing a valuable employee to keep another? How do you choose which person is more valuable to the practice? I’d like to think that all of my employees knew how much I appreciated them and how valuable they were to me, but I don’t take to threats well.

Even an experienced, long-term employee should not threaten their superior or doctor. If an employee is so unhappy that they are giving their superior an ultimatum, I suspect that nothing will ever make them truly happy at that practice. Eventually, they will find other things to complain about. And if you give in to their threats, they will feel empowered to take advantage of you again in the future. On top of that, you are sending a message to the other employees that you are not truly in control. The rest of the staff sees the employee getting away with things and think that the practice leader is allowing their poor behavior.

While it may feel like a single employee is irreplaceable, and training a new employee is extremely time consuming, in reality, everyone is replaceable. I would tell the disgruntled employee everyone has tough decisions to make. If they are truly unhappy because of another individual, they should decide if they want to continue employment there or not. If they want to continue, then they have to learn to work with any employee that management feels is deserving of a job.

Thuy-Lan Nguyen, OD, practices in South Florida, teaches at Nova Southeastern University College of Optometry, and works part time as an associate at We Are Eyes in Boca Raton, Fla. To contact her:

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