Your greatest challenge as a practice owner isn't the dentistry — it’s managing people. To help you overcome the inevitable conflict you will experience, Kirk Behrendt brings back Miranda Beeson, one of ACT’s amazing coaches, to share two frameworks for addressing challenges between leaders, team members, and patients. Don't let conflict become a crisis! To learn the best ways to resolve conflict in your practice and your life, listen to Episode 641 of The Best Practices Show!
Episode Resources:
Links Mentioned in This Episode:
Listen to Episode 529 of The Best Practices Show
Read books by Stephen Rollnick
Read Crucial Conversations by Al Switzler, Emily Gregory, Ron McMillan, Kerry Patterson, and Joseph Grenny
Main Takeaways:
Each person has a different background with conflict resolution.
Understand the difference between conflict and confrontation.
Master the use of “I” and “you” statements.
Let go of your need to be right.
Listen more, talk less.
Quotes:
“Everyone is coming from a different place and a different background around how they manage conflict. And right off the jump, I want to set apart — this isn't confrontation. Conflict and confrontation are two different things. Conflict is just a difference of opinion, in some capacity, between two people or two parties.” (3:55—4:14)
“Three percent of the population are D style personalities, which, D often stands for direct or dominant personality style. If only three percent of the population have a personality style that's willing to take on conflict directly, that means 97% of the world are not. So, anyone listening that's like, ‘That's me,’ it's okay because you're in the majority. That's why we're doing this podcast. So, mindset does matter. You have to be really intentional about wanting to improve the environment and grow as a team or as a leader around taking on conflict.” (6:14—6:53)
“Again, like we said, it's not confrontation. It's just, how can we decrease that gap between expectations and the reality that we're seeing. And we have to let go of our need to be right, or to go into it as if we have to win, or that our solution is the only way. And so, any time we approach conflict, it's important to be really, really open to new possibilities, to new ideas, and listen to the other person. That's a part of that conflict conversation. And then, also gently share our ideas so that we can have a conversation about it. The goal is that both parties end up satisfied, feeling heard, and having a mutual outcome that's going to benefit the practice and our future relationship.” (6:53—7:40)
“There's this thing called resisting your righting reflex, and it's one of my favorite aspects of the concept of motivational interviewing. It's so hard to do. Most of us, in any given situation, want to be right and want to be heard, and it's so important to resist that reflex to want to “right” the other person. ‘No, no, no. That's not how I see it. No, no, no.’ Your version of the truth is not the same as theirs, and so we just have to agree that we have different versions of the truth, and how can we get to a compromise and resist that reflex to “right” the other person.” (9:28—10:05)
“Resist your righting reflex. The example I use when I talk to dental professionals, especially hygienists . . . is when you have a patient who you've recommended periodontal care to, and they didn't move forward but they come in next time and they say like, ‘I'm so excited because I bought that gum detoxifying toothpaste. I saw the commercial. I can't wait for you to tell me it's going to look so good in there.’ And in my mind as a hygienist, I'm like, ‘I know darn well that that toothpaste didn't cure your periodontal infection.’ But I'm not going to immediately stop and “right” them and say like, ‘That doesn't work.’ I'm going to go, ‘Oh my gosh, I'm so glad that you heard what we were talking about last time that there were concerns there, and you went and took some action. Let's look at that together and see how you're doing.’ The reality is, they're not going to be doing any better than they were. But I'm not going to take advantage of that situation and “right” them in that moment. I'm going to resist my righting reflex, and then take it as an opportunity later to work on that problem together. They'll see it for themselves, eventually.” (10:14—11:18)
“The ARCH method, it's an acronym. A stands for acknowledge and agreement. R stands for request. C is confirm. H is hope . . . We’ll start with the A, acknowledge and agreement. What we want to do right off the jump to help ease any tensions around the conflict is acknowledge or agree to what we can about the issue. So, the other person has a point of view, and there's often a common place within the conflict, or within the situation, on which you can agree on something. If you can find one thing within this point of conflict that you can agree on, starting with an agreement or some acknowledgment of an agreement, that can be a really great starting point to immediately diffuse some of the tension within the conflict. So, if you're listening to gain resolution, there's usually something within their perspective that you can agree upon.” (11:56—12:57)
“Sometimes, we need to step away, regroup, and allow that frontal part of our brain to get into a more linear thinking fashion. And I say even write this down. Have a piece of paper that has ARCH, and you sit down and work through those thoughts for each one. Get it on paper. You can even use the piece of paper, if you need to, in guiding through the conversation. You can tell the other person like, ‘I'm really trying to do a better job of managing conflict conversations.’ There's a book called Crucial Conversations that I really love. ‘I'm trying to do better at managing these crucial conversations. I'm going to use this paper because I wrote down some thoughts because I want us to really end up in a good place with this.’ I mean, how cool would it be if you had someone coming to you with that much thought into how they're going to approach you to make sure this goes well, versus just coming at it emotionally flooded?” (14:43—15:39)
“First and foremost, stop. Instead of, ‘I want this person to understand where I'm coming from,’ it's, ‘Maybe I should take a minute to try to understand where they're coming from.’ That's responding versus reacting. And we've all done that with the text message. You type it out, and then you erase it, and then you type it out, and then you erase it. If you're doing that, just don't reply until tomorrow morning. Good rule of thumb.” (16:19—16:46)
“With acknowledge [in ARCH], a common occurrence within a dental practice is when somebody feels like they're the primary person managing sterilization — it comes up a lot. ‘Only so-and-so is in there. The other person is not.’ So, say you have two dental assistants and they're in conflict because one of them feels like they're carrying way more of the load around managing sterilization, and the other one is just seeing patients and not doing any of the extras. So, if we look at acknowledge, and you're being confronted by this person in this conflict way, again, easy. ‘I totally agree with you, Suzie. There are a lot of responsibilities that we're both responsible for, and we should share the load.’ So, Susie comes to me and says, ‘I don't think you're doing enough to help with sterilization. I'm in there all day long. I never see you come in there when I'm in there, and I'm just really frustrated.’ So, to acknowledge or create a place of agreement, I can say like, ‘Susie, you're exactly right. There are a lot of extra responsibilities outside of just seeing our patients. I think we should share the load.’ Now, that doesn't speak to why I'm not, and, ‘Yeah, but you did this last week,’ because we have to be moving forward in the conflict. But we can at least agree that there are a lot of extra responsibilities outside of patient care and we should share those responsibilities.” (17:19—18:44)
“Once we've reached that place of acknowledgement and agreement, the next piece, which is the R, is request. So, making a request, either for a solution for an idea from them to contribute, possibly to request bringing someone else into the conversation if we feel like it's elevated beyond what we can facilitate on our own. But the main thing is we want to keep the conversation moving forward. So, we start with an agreement piece. And now, to keep moving forward, we're going to make a request. So, in that same example, I might say like, ‘I really do try to help throughout the day. I just get so busy that I really can't find the time very often. Maybe you can share with me how you're working the time in. If you feel like you're in there throughout the day, maybe you can help me figure out what you're doing different than what I'm doing so that I can be in there more often.’ So, that's a request from that person to start moving into solving the situation.” (18:45—19:41)
“After we've made the request and we discuss what that looks like, so, Susie has shared with me, ‘Well, what I normally do is this. Maybe you could try doing that,’ or, ‘Hey, what if in the morning we look at the day, and I'm in there in the morning, and then you go in after lunch, and you're the one who primarily does it after lunch?’ ‘Okay, great.’ Now, we want to confirm what that solution is that we've discovered together after making our request. We want to make sure that once we've made an agreement, we confirm the details. Too many conversations go wrong, or the conflict repeats itself because we weren't clear. So, we might have discussed a solution, but we both heard that solution a little bit differently. If we actually verbalize and make a lot of clarity around what we've decided to do to help solve this, then we're all going to be really clear on the expectations. So, literally say out loud a summary of what you heard the conclusion to be and what that path forward is.” (19:48—20:46)
“Once you've confirmed what this solution is, what our path forward is, we now have this level playing field, this new expectation, that if we honor it and we do both move forward and honor this commitment we've made to each other, now you do have this elevated level of trust between each other where you're going to feel more comfortable next time going right into that conflict conversation because it was so successful the last time.” (22:23—22:48)
“We all know that sometimes it does work out where that person still doesn't go in after lunch to do their part of sterilization. But we've created this new, clear expectation where we can now go back to that conflict. This is where you and I say often, we can't argue with our own data. Someone can't argue with their own data. If you have verbalized this commitment to each other and you've set this clear expectation, if it doesn't happen, we can come back to this conversation using the same method and go back through our ARCH steps and say, ‘We made this commitment. Here's my request from you. And now, we're going to have to find a new path forward.’ So, what I really love is it does help to build that vulnerable based trust because the majority of the time, it ends up really solid. We all take action on that path that we agreed upon and we go, ‘Oh my gosh, I can have a conversation about a difference of opinion or something that's bothering me, and I can have a really positive outcome from that. How about that? Maybe I'll try it again sometime.’” (22:52—23:47)
“Hope is ending that conversation and that conflict conversation with positive gratitude around being able to take this on together, looking at the good of what's to come from it all. What is this better outcome that we're going to be moving into? Really communicate your optimism and hope for the future that's going to come from this new agreement. So, if we look at the example we were given, ‘I'm really glad, Susie, that we were able to talk about this. I really don't want you feeling like you carry my share all day as well. I hope that trying this new way where we split the day is going to lighten the load for both of us. This might be a better option than we ever would have come up with if we hadn't had this conflict.’ So, looking at the future and being really hopeful for what this decision and resolution that we came to together can really provide that's going to better our lives in the end.” (23:54—24:47)
“A lot of people like to receive feedback in that positivity sandwich of something really good, the tough stuff in the middle, something really good. That's really what the ARCH technique provides because, in the beginning, we're starting with that really positive mindset and diffusing the emotion around something we can agree upon so that we're starting off in a more positive place. Then, we're ending it with that statement of hope and statement of gratitude. Hopefully, people are genuine about their hope and gratitude for being able to take this on and be better in the long run because we were both willing to work through this together.” (25:51—26:25)
“The great thing about the awareness wheel is it makes everything about me. I have a problem with a team member, a colleague, or a patient, for that matter. That's probably the example we'll use today, is when someone is late. And you can relate it to a team member or to a patient. But it really is all about me. We use objective data, facts that we can't argue with, and then how do I feel about it, what do I want in the long run. We really avoid “you” statements throughout the awareness wheel as much as possible. So, if you imagine a wheel, there are several components within that wheel. We start with sharing what is. Like, what is the fact at hand that is inarguable amongst either person involved in the conflict? And there are no “you” statements going on here at all. It's just what is.” (27:12—28:04)
“We want to make sure that it's not about an opinion. And we can't turn this around to the person bringing up the conflict and saying, ‘You feel this way about me,’ or, ‘You're just storytelling. You're making assumptions.’ No, we want to make sure it's very clear. And if you flip this to a patient being late for their appointment, ‘Susie,’ I keep using Susie. Poor Susie. ‘Susie, we agreed that you would be here at 7:00 a.m. with Dr. Awesome, and you arrived at 7:15 a.m. for your one-hour appointment.’ So, there's no this, that, or the other about it. That's just what happened. ‘You agreed. You confirmed it at 7:00. You showed up at 7:15. We now only have 45 minutes.’ It's just a fact. And we can deliver it in a very kind way.” (29:57—30:41)
“The next piece of this wheel or puzzle is sharing an “I” statement, usually leading in with something like, ‘I imagine,’ or, ‘I assume,’ so that it’s, ‘This is what I'm thinking about the situation. Tell me if I'm right or wrong.’ So, in the same example around huddle, we can say, ‘I imagine that something really important has been holding you up,’ or giving them the benefit of the doubt. Or, ‘I imagine that you don't realize the impact that you being late to huddle has on the team and to our day,’ but just putting out there, ‘This is what I'm assuming. This is what I'm imagining about the situation.’ So, again, it's an “I” statement, and it allows for what I'm creating in my mind around this scenario to be put into the space because there may be something that we don't know. We may be creating a little bit of storytelling, and they will have the opportunity to then share their side of what that all means. And they may say, ‘You know what? You're right. I've really been struggling taking care of my elderly mother. She moved in with me. I didn't tell you, but she's got dementia now and it's really hard to get out the door in the morning.’ Wouldn't you want to know that so that you can be supportive of your team member if something's changed in their life?” (30:42—31:55)
“After you share, ‘What I imagine,’ or, ‘What I assume,’ you want to share your feelings. For example, in this scenario, you're going to leave with an “I feel” statement, an “I” statement. ‘I feel concerned that patient care is going to be affected because you're missing important details at that first part of the huddle.’ And then, the next piece is another “I” statement, ‘I want,’ or ‘I desire.’ So, ‘I want for all of us to uphold our team agreements and start our huddle at 7:10 so that we can be best for our patients throughout the day.’ And then, the last piece is going to be sharing an action item or the next step. So, ‘I will count on you to be here on time moving forward and letting me know if there's a reason that that isn't feasible. So, again, if we go back to what all those pieces are, it's sharing what is, and then sharing an “I” statement around, ‘I imagine’ or, ‘I assume,’ whatever it is, the story that you're telling yourself about the situation, and then share your “I” statement around your feelings. ‘I feel this way about the situation because,’ and then, ‘I want this to happen as a result,’ and, in the end, what would be the agreement or the next steps that we need to put into place in order to get there.” (32:08—33:20)
“[Making “you” statements are] going to create a defense mechanism right off the jump with the other person that you're talking to. Like we were saying before, we want to make sure that any type of conflict conversation feels like, in the end, there's this mutual benefit and that we leave on a positive note, and it doesn't become confrontation. If you start making accusations without really knowing the details, then they're going to respond in a very defensive nature versus, ultimately, if I'm upset about this situation with Susie being late to huddle, that's a me problem right now. Susie doesn't even know this is a problem right now, but I've been dwelling on it in my mind for a whole week every single time she walked in the door late. And so, right now, it's a me problem, and my responsibility to my teammate is to let them know how I am feeling about it to give them the opportunity to then share what is the truth on their end about why this is happening, and how can we collectively make an agreement to move forward that's going to be beneficial.” (33:45—34:52)
“Put very clear expectations out, and then reward consistently when people meet those expectations, and then correct consistently when they're not meeting those expectations. The really important piece here is expectations. So, if a team member, a doctor, practice owner that I'm working with comes to me and says, ‘I don't really love what Jane has been wearing to work lately. I feel like it's not quite professional enough.’ Okay. What's Jane's expectation of what she's supposed to be wearing to work? Have we made that really clear? Or, ‘We have so many patients that are arriving 10, 15 minutes late.’ Okay. What's the expectation that the patient has around their arrival time? Are they expected to be early? On time? Do they expect that it's okay to have a grace period? What have we created as an expectation within the practice? And then, if we haven't, now we need to set an expectation. That's what this [framework] gives us an opportunity to do, either correct on those expectations that are not being met in a way that is not confrontational but constructive, or set a clear expectation around something that maybe we haven't been really clear about in the past. But there's a conflict within us, and that person doesn't even know that we're in conflict because that expectation hadn't been set clear before.” (36:26—37:50)
“Really important in any crucial conversation like this is to keep moving forward, not talking backwards. Very rarely are we going to agree on what the situation looks like or the circumstances that happened in the past. We're going to see them in a different light. That's why we're in conflict. So, the most important thing is, don't talk backwards as much as possible. Once we get the fact of the matter out there, let's keep moving forward and redirecting the conversation into creating new and better solutions and a new future where we can find agreement and move forward instead of focusing on what's happened in the past. We're never going to make progress if we revert to the past.” (38:05—38:49)
“Listen more and talk less. It takes us back to the very beginning of our conversation on this podcast around how important it is to not just get your opinion across but really listen to the opinion of the other person. Conflict doesn't happen with just one person. It takes two people to end up in a situation where we need to have these conversations, and our opinion is not the only one that is relevant, or important, or that matters. There's a phrase that I learned long ago, which was, ‘Be interested, not interesting.’ It's just as important to hear from someone else and be interested in their perspective as it is in sharing your own. You have to seek first to understand before you can be understood.” (38:57—39:42)
Snippets:
0:00 Introduction.
1:53 Why this is important for your practice.
3:09 Different backgrounds with conflict management.
5:59 It’s not about confrontation.
8:55 Resist your “righting” reflex.
11:20 The ARCH method, explained.
26:27 The Awareness Wheel.
33:21 “I” statements versus “you” statements.
35:52 E – R = C.
37:58 Last thoughts.
Miranda Beeson, MS, BSDH Bio:
Miranda Beeson, MS, BSDH, has over 25 years of clinical dental hygiene, front office, practice administration, and speaking experience. She is enthusiastic about communication and loves helping others find the power that words can bring to their patient interactions and practice dynamics. As a Lead Practice Coach, she is driven to create opportunities to find value in experiences and cultivate new approaches.
Miranda graduated from Old Dominion University, and enjoys spending time with her husband, Chuck, and her children, Trent, Mallory, and Cassidy. Family time is the best time, and is often spent on a golf course, a volleyball court, or spending the day boating at the beach.