Stop Workplace Drama in Your Healthcare Organization

Let’s face it, there’s plenty of drama in healthcare that’s not related to people, including administration, reimbursements, legislation, technology, HIPAA, Medicare, pay for performance, and the costs of running a healthcare system, to name just a few.

Although these challenges are beyond their control, physician leaders can use their leadership skills to significantly reduce people-related workplace drama, whether it’s gossip, backstabbing, insubordination, constant complaining about what’s not fair and who is to blame, and hundreds of other manifestations. What keeps leaders on the hamster wheel are their attempts to figure out what or who is causing the drama.

• For Roger, a C-suite executive, the drama is dealing with a world-renowned physician who is disruptive.

• For academic chairperson Reanna, it’s a micromanaging dean who doesn’t support her even after agreeing privately to do so.

• For Jocelyn, a practice executive of an internal medicine clinic, it’s a nurse practitioner who acts like a queen bee.

• For Chris, the CMO of a large group practice, it’s the turf war between one of the physicians and the IT manager — a power struggle that compels them to tattle on each other.

What about you? Even though you are the one who was hired to fulfill a leadership position, you continue to work in the boiler room shoveling coal instead of navigating on the top deck. You often take on everyone else’s issues and feel depleted, frustrated, or overwhelmed. Sometimes you feel stuck in the middle. If only you could get the support of your colleagues or your boss.

There is an elephant in the room. Massive changes are looming, and you sense the resistance. Doubt starts to creep in. Do you have what it takes to make the necessary changes?

I’m assuming you are great at what you do. You understand business. You have the best intentions for the healthcare organization. You have the skills, and someone picked you to lead. With your experience, you might even say that the department would fall apart without you. If this is true, then why are you starting to lose faith in yourself? Why haven’t you had the courage to initiate a difficult conversation with the person or the people who are part of the drama you experience?

Perhaps you are already short-staffed and you can’t afford turnover, so you accept the status quo — for now. Or maybe your supervisor has a huge blind spot. You don’t know how to initiate a conversation without creating defensiveness. Or perhaps taking on everyone else’s issues is clouding your judgment.

All physician leaders likely deal with their fair share of office gossip, turf wars, lack of support, and difficult employees. Before we explore the skills necessary to rip drama out by the roots, let’s lay a foundation by examining some definitions of workplace drama.

Drama Defined

Drama can be defined as any obstacle to your peace or prosperity. Picture a person in a rowboat, a shark, and an island. The captain of the rowboat is trying to get its passengers to an island called Peace and Prosperity, but there’s a shark in the way (see Figure 1).

As the captain, your job is to keep yourself and the entire team focused on reaching the island of Peace and Prosperity. Sometimes the team members beat each other with the oars and you have to get them refocused. Sometimes they try to distract you by rowing toward the islands called Not Fair, Not My Job, You Don’t Understand, or any of the thousand other distraction-islands.

These challenges are represented by the shark. Sharks reside in the physical realm and in the invisible realm. A shark can be:

• The problem that takes up space in your mind.

• The resentment you have toward an employee.

• The employee who undermines your authority.

• The backstabbing colleague.

• The colleague who bullies.

• A new mandate from the government.

As captain of the boat, you know that if leadership is about anything, it is about alignment, and alignment is about focusing energy. Focusing energy is difficult enough when you are in the boat by yourself; the task becomes tougher when you are trying to guide an entire team. And, it’s nearly impossible when you have a leak in the boat and no one wants to plug it.

Viewing drama this way, you are able to separate yourself from it, viewing it from a bridge overhead and from different perspectives in the boat. When you are able to separate yourself from your drama, you have the power to pull it up by the roots instead of continuing to nip it in the bud.

Nipping drama is like snipping off the tops of dandelions in a field. The problem looks like it’s been solved, but next year there’s a new crop that has doubled in size. Nipping includes:

• Promoting an incompetent employee.

• Moving an employee to another rotation or department.

• Giving difficult assignments to show who is boss.

• Showing favoritism or unfairness.

• Manipulating by being extra nice.

Bud-nipping wastes your time and contributes to game-playing and avoidance.

How do you know if you’ve been nipping versus pulling roots? By the results. If you continue to experience the same problem over and over, it means there’s a pattern in place and the root system is still alive and growing. When you eliminate the root, the bloom (the pattern) no longer exists.

Dealing with the Drama

Have you ever had or witnessed an emotional meltdown at work? Chances are the outburst didn’t come out of nowhere; it likely stemmed from little infractions or behaviors or innuendos that went unaddressed over time. The benefit of the doubt was offered one too many times. The exception became the rule. The individual who contributed to the meltdown was never confronted. Or maybe the problem was addressed a thousand times but boundaries were not enforced or the person was not held accountable.

The financial health of an organization depends to some extent on the leader’s ability to identify and stop drama. You can’t make informed decisions when you base your decisions on emotion only. Knowing your feelings won’t change the facts but knowing the facts can change your feelings. The ability to discern fact from fiction is a wonderful gift you can give to the organization.

One of the biggest myths is that we can separate our personal life from our professional life. Emotions are energy and energy always needs to go somewhere. Sometimes the energy from unresolved issues in your personal life leak into your professional life. When you are struggling inwardly, it shows on the outside, even if you don’t talk about it.

Yes, you need to set strong boundaries between home and work; however, even with boundaries, you still bring your whole self to the office. Your personal problems take up space in your head and affect your energy and decision making. When you learn how to balance your emotions and deal with the issue at hand, your mind becomes clearer, more focused. This helps you not only in your leadership role, but in your life.

Finding Clarity

You may believe that there is one person in your organization who causes the drama. It might be a clinician, a CMO, an office manager, an IT manager, a nurse, your boss, or your employee. You say to yourself, “When that person leaves, everything will be OK.”

One day the person leaves. Hooray! Problem solved! Six months later a similar pattern emerges. The drama is back. What happened?

The root of drama is not a person or a situation, it’s a lack of leadership clarity. There are three areas of clarity that must align across the organization:

1. Clarity about your choices as a physician leader.

2. Clarity about who is in charge and how decisions are made.

3. Clarity about roles and responsibilities.

The good news is that as the leader, you have the power to change the situation. In fact, the best way to grow as a leader is to take 100 percent ownership of the problems, because only then do you have the power to get your organization and your life on the right track.

Let’s look at each of the three areas of clarity.

Clarity About Your Choices

If you are not happy in your job, and if you are not supported by the people who are in charge, you will be miserable. You must stand on your own strength before you can lead others. You must have the courage to collaborate with your administrators about what you need in order to successfully implement the vision of the organization.

Remember that you have choices. When you recognize that you have choices, you remain powerful. Have the courage to communicate strategically with your bosses, to express your frustrations and concerns. The goal is to reach a mutual understanding. If you have tried to collaborate with your supervisors to move the organization forward and still don’t have the support of your boss, remember again that you have choices. One choice may be to find another job.

It’s easy to become a prisoner of a bad work situation. You tell yourself you can’t give up now after all these years. You keep wishing things would turn around. But if the same patterns with the same people keep repeating, or if the same patterns repeat with different people, it means you are making the same mistakes without recognizing them as mistakes.

The lack of clarity or the feeling of powerlessness is common. Sometimes a physician doesn’t feel empowered dealing with another physician, with a workplace bully, or with those who don’t mesh well. No matter what your position, if you recognize any of these problems, it is because on some level people are allowed to get by with unproductive behaviors. This boils down to not knowing who is in charge.

Clarity About Who Is in Charge and How Decisions Are Made

When physician leaders, physicians, and administrators are not on the same page, the lack of alignment can lead to workplace drama. Employees manipulate. Rules are not respected. Boundaries are crossed. It isn’t long before confusion sets in.

When employees understand who is in charge and how decisions are made, they work well together. There is no confusion about who is in charge and about consequences for misbehavior. This clarity is the key to knowing where you are going, what is expected, and whether you are succeeding or need to course-correct.

Clarity About Roles and Responsibilities

Every position must be clearly defined and people in those positions must understand how their roles relate to the roles of others. One physician leader shared, “My boss constantly blindsides me with additional tasks.” Being “blindsided” by tasks is evidence that either the physician leader does not understand the roles, or that he or she is not aligned with the peer’s vision of how to align roles and responsibilities.

An organization I worked with recognizes the importance of training doctors to understand what to expect from the various roles. A new associate would come on board and the doctors wouldn’t have any idea about who did what. Much of the confusion and lack of clarity was due to an ineffective employee handbook.

A game-changer for the group was the revision of the employee handbook. Now everything is in writing. When there’s a question or a disagreement, the physicians look at the handbook first. When a new employee is hired, the physician leader says, “Here is who I am to the organization and my job description. Here is our handbook and our culture. All of my authority comes from the doctors.”

Getting Aligned

Understanding roles and responsibilities also helps initiate difficult performance conversations. If you are clear with your employees about your choices, about who is in charge, and about how decisions are made, and you are clear about the roles and responsibilities in the workplace, you have a great framework for clarity in your organization. If you still struggle with workplace drama, the lack of clarity may be an issue of alignment.

Until there is clarity, there can be no alignment. You have to know who you serve (your patients), why you do what you do, and what character traits describe your interactions with patients and with each other.

Knowing who you serve is fairly easy. You serve patients who have chronic diseases. You serve patients who have problems with their eyes, ears, nose, or throat. You serve patients who have cancer. In pediatric practices, you serve the pediatric patients as well as their parents. Who you serve determines your specialty and the services you offer.

You must hire people who align with your mission. The clarity between the top leaders and the values of your business become the North Star by which decisions are made. For example, if respect is a top value, you discipline employees who use vulgar language or who engage in the harassment or bullying of others in the workplace. To allow an employee to continue unproductive behaviors that don’t support your mission, vision, or values creates misalignment. Misalignment eventually costs your company money, whether through a lawsuit, turnover, absenteeism, or patients.

You have to get clear before you can align to that clarity. Translated: You can’t row to an island if you don’t know what the island is to begin with.

Elevating Leadership

Let’s look into the future for a moment. You have read this article to gain clarity. You have put into practice some simple suggestions and you have paid your dues. You are courageous. You have become the highest version of the leader you knew you were capable of being. You are no longer a drama magnet. You have more energy to live life and give back to the career you so dearly love. You don’t waste time in unproductive conversations that look like a ping-pong match.

You demand and receive the backing and the respect of the physicians, peers, administrators, executives, and other decision makers with whom you work. You don’t let petty problems take up residence in your brain. If you need to let someone go, you do so thoughtfully, but with no regrets. You know in your heart that if you ever need to move on, you can do so without blaming yourself or anyone else.

I hope the visual of the rowboat, shark, and island, and the guidelines on how to establish clarity will help you gain clarity about your choices so you can manage your priorities and reach your leadership potential while still living a good life. I believe we are on this planet to discover, develop, and deliver our gifts. When we are distracted and veer off course because of drama, we stop experiencing life to the fullest.

We live in paradoxical times. With the advancements of technology our lives have become more complex due to the overwhelming choices and information vying for our attention. We have more speed but less time. We have more opportunity to connect but less real live connection. We have more choices but less self-control.

It is possible to work around the clock and it’s easy to become addicted to the adrenaline of worry and to the chronic belief that there is not enough time or that there are not enough choices. We then start to buy into an idea that we are not enough — that everyone else must have it figured out, or that one day things will magically improve. We believe that until then, we have no other choices than the ones before us. These are stories we tell ourselves to cope with the ever-changing demands in life and in business.

We are living in an environment that contributes to drama: extreme speed, change, and uncertainty. Arm yourself with the understanding, philosophies, wisdom, knowledge, and skills to elevate your leadership in this ever-changing landscape.

Signs You Are Losing Control

Feel like you may be losing control? Here’s a quick checklist to determine if you need to course-correct:

• Open door becomes revolving door.

• Employees say “Not my job” when asked to help.

• Your seniority is used against you.

• Your supervisor does not back your decisions.

• You walk on eggshells around someone.

• You’ve told them a thousand times, but nothing changes.

• Employees show excessive tardiness.

• Rules are not adhered to.

• There’s low morale.

• Employees show rude, inappropriate behavior in the workplace.

• Turnover is excessive.