Kendall L. Stewart, M.D. 

Why are physician leaders hesitant to do this?

Feelings are highly contagious. When one of your colleagues is angry and spraying invective in every direction, that arousal will be hard to tolerate. Just like everyone else, you would prefer to avoid such unpleasantness. The last thing you will want to do is fight that fire. You know you may get burned in the process. Your unreasonable colleague will not welcome your efforts to manage her feelings—unless you unconditionally accept her behavior as justified. That is not likely to happen. If people managed their own feelings appropriately there would be no need for leaders to manage them.

What is the case for doing it anyway?

Emotional outbursts, particularly by people in power, cause real problems in the workplace. Disruptive behavior by physicians is unfortunately common, and the victims expect physician leaders to step up and deal with it. When leaders do their jobs everyone calms down, confident that such outbursts will not be allowed to disrupt their lives forever. When leaders cower in the face of unpleasant feelings and fail to manage them, the best people start to wonder whether they should look for a better place to work—a place where physician leaders do their jobs. However unpleasant the task of managing others behavior, you cannot permit this to happen.

How can you do it?

1. Contain the outburst if possible. If you are present or can respond immediately, take the bad actor somewhere private. Isolate the contagion and minimize the emotional damage by moving the erupting colleague to your office or someplace else off stage.

2. Accept everyone’s feelings. This is not the same as approving their behavior. We all have feelings and we are entitled to them. We are not entitled to behave disruptively because of them.

3. Begin a dispassionate investigation. Talk to everyone who personally saw what happened. Ask them to document what they observed. If only two parties were involved, interview them individually.

4. Do not take a position prematurely. Complainers can be very convincing. When you talk with other players, you will usually discover that others have very different perceptions about what happened, how the participants behaved and whether their behavior was professional.

5. Do something. Document your findings. Take a position. Identify the behaviors that were out of line while suggesting more appropriate ways to manage such strong feelings in the future.

How have you observed physician leaders manage others’ feelings effectively?

Kendall L. Stewart, M.D. 

Why are physician leaders hesitant to do this?

We all have feelings. Most of us take them too seriously. People, including physician leaders, usually let their feelings rule their lives. Accustomed to letting our feelings dictate the way we interpret events and behave, it may never occur to us that these powerful forces simply cannot be trusted. We are all inclined to go with our gut. And managing your feelings is hard. It’s easier to go with the flow even when the emotional current is taking you in a dangerous direction.

What is the case for doing it anyway?

Others will look to you to help them deal with their feelings. Learn to deal with yours first. If your feelings are always yanking your chain, you will not be able to recognize others’ feelings, understand them and help them put them in perspective. People who are upset look to leaders to help them manage their internal turmoil. If you are upset too, you will just make matters worse.

How can you do it?

1. Recognize your feelings before you act on them. You must first be comfortable in your own skin. If you’ve fallen into the habit of ignoring your feelings, you will need to make some significant changes.  Even the least guarded among us will find that identifying, accepting and expressing our feelings before we react to them demands an arduous self-discipline.

2. Wall them off temporarily. Once you recognize your feelings, you can put them aside for a time while you respond to how others feel. We all do this to some degree as a way to get through our daily lives. Successful leaders do it more frequently and effectively.

3. When you have a free moment, examine the feelings you have temporarily shelved. Identify them, face them squarely and accept them as legitimate. Look for what triggered them. Accept the discomfort they bring.

4. Resist the urge to act impulsively. Feelings urge us to act. We often act on these urges without even recognizing the underlying feelings and before we have considered our options. Doing nothing is always an option. In an emotional storm, it is often the best option.

How do you manage your feelings?

Kendall L. Stewart, M.D. 

Why are physician leaders hesitant to do this?

We physicians don’t pay much attention to anyone’s perceptions but our own. We are in demand. Positions are plentiful. Patients line up and wait patiently to see us. When pressed, we will acknowledge that not everyone perceives us favorably. That is their problem. People should not expect a brilliant physician to be nice too. But if you don’t accept others’ perceptions as valid, you cannot hope to manage them.

What is the case for doing it anyway?

Successful physician leaders understand that everyone has perceptions and that they matter. They understand that these perceptions can and must be managed. This does not mean that they can change others’ minds completely, but they are confident they can influence and manage the reasonable person’s perceptions.

How can you do it?

1. Recognize that this is your duty as a leader. If you don’t recognize this critical leadership skill as one of your obligations, you will behave just like the typical physician. You will spend most of your emotional energy dismissing others’ perceptions as ridiculous. And you will dig yourself a very big hole.

2. Stop being defensive. Concentrate on indentifying and understanding instead of resenting those who disagree with you. You cannot manage perceptions you don’t recognize or respect.

3. Clarify others’ perceptions. When your colleagues realize you are trying to understand their perspectives, they will be more forthcoming. Once they feel understood and appreciated, they will be more open to considering differing perceptions.

 4. Correct misperceptions. For a variety of understandable reasons, people draw incorrect conclusions all the time. You do too. They may have been given false, misleading or incomplete information. Correct this without condemning their reasoning process. And bear in mind that, sadly, beliefs are stronger than facts.

5. Acknowledge their perceptions and ask permission to suggest another possible explanation. People draw conclusions and feel strongly about them. Admit that their assumptions may be accurate, but then ask whether they have considered other possible explanations for your behavior. This is the opening you are looking for in your attempt to manage perceptions. You will never bring everyone around to your point of view, but you can persuade some that your motives were more reasonable than they first suspected.

What practical strategies have you used to manage others’ perceptions?

Kendall L. Stewart, M.D. 

Why are physician leaders hesitant to do this?

Physicians, like everyone else, are pretty good at talking about their colleagues behind their backs. We are not so good at confronting our fellows directly, holding them accountable when they misbehave or fail to follow the appropriate procedures. Knowing that confrontation is never welcomed and fearful that we might soon be on the receiving end ourselves, we do our best to avoid it. No one rolls out of bed in the morning hoping to confront someone later that day.

What is the case for doing it anyway?

Confrontation is an essential part of the leadership job description. You don’t have to like it, but you cannot avoid holding others accountable if you expect to be effective.

How can you do it?

1. Stop avoiding it. Accept that holding others accountable is your responsibility as a physician leader.

2. Create a confrontation checklist. Every successful confrontation contains certain elements. Miss one or more of them and you will be less effective. You might even make matters worse. You can review a practical presentation about confrontation here.

3. Find an effective coach. Some leaders are better at this than others. Find a local expert. Watch them at work. Ask them how they plan a confrontation, and inquire about the attitudes they create before these crucial conversations.

4. Practice beforehand. Like any other skill, confrontation can be learned. The learning will be less painful if you role play with a colleague before the tension is so thick and the stakes are so high.

5. Solicit feedback and make a commitment to improve. Thankfully, you won’t have to exercise this skill every day, but you will get a good bit of experience over time. Invite one of your colleagues to observe and critique your performance every time. Make improvements in your delivery as a result.

How do you prepare to hold others accountable?