A patient comes in expecting to be seen at 11:30 but sits in the waiting room until noon or even longer. Potential conflict. A physician expects a nurse to send a prescription to a pharmacy but it never arrives. Potential conflict. An administrator expects staff to abide by a new policy, but many people aren’t. Potential conflict.
Conflict often stems from unmet expectations, and let’s face it, we have a lot of those in healthcare right now. In one survey by the Medical Group Management Association, 71% of the healthcare leaders polled said that conflicts with patients increased in 2021, mostly due to unmet expectations. We also see proof of the problem in employee surveys, in higher-than-ever burnout rates, and in lost staff. Nobody expects to work more than they can handle, to have little control over their work, or to feel morally compromised.
As leaders, we often don’t have the luxury of focusing on “jobs to be done” right now—contracts to negotiate, new processes to implement, data to examine. Despite our own stressors, we first need to think about our people and how to support them mentally and emotionally. We have to tackle the issues contributing to burnout. Interpersonal conflict in the workplace—between colleagues and with patients—is a big one. The two problems fuel each other in a vicious feedback loop, and organizational cultures based on old-school power dynamics cinch the loop tighter.
Too often, though, we’re putting a Band-Aid on an arterial bleed. We’re managing conflict interaction by interaction. Unmet expectations could be momentary irritants, but they evolve into unproductive conflict when we don’t pause and get to the root of the issue. Psychologist Adam Grant has explained how conflict emerges as we progress up the “ladder of inference”—from making observations to making assumptions to drawing conclusions to taking action. The patient makes a faulty assumption that staying on schedule isn’t a priority for the doctor, draws a conclusion that she doesn’t value her patients’ time, and then behaves accordingly.
We can use our influence to correct that progression up the ladder and stop more conflict before it starts.
First, we need to recognize that we can’t resolve conflict or build a low-conflict culture if we’re actively contributing to it. Managing conflict is an important element of emotional intelligence. But as our cortisol levels rise—due to staffing shortages, new regulations and policies, financial struggles, and an uncertain future—we tend to swerve between conflict and avoidance, and both of those narrow our thinking. Leaders need to look within—influencing our own expectations, assumptions and behaviors. If we can find the bandwidth to do that effectively, we’ll immediately shift the tone with our teams.
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One simple strategy for each of us is to reflect on the frustrations you’re feeling. What are the unmet expectations behind them? What assumptions are you making? What’s the (possibly faulty) story you’re telling yourself about other people or the situation?
Then you can use the same approach with your team or patients when unmet expectations land in your inbox or show up at your door. You can encourage more perspective-seeking, because most conflicts can be cut off with conversations that build understanding or empathy and improve our assumptions. It takes some time, but the alternative is to waste more time and energy on avoidable conflict. You can save even more time and curb even more conflict by having more productive conflict—open, safe discussions in which people share differing perspectives or concerns.
