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It takes time and effort to create positive work relationships, but the payoff is worth it.

Fam Pract Manag. 2006;13(10):45-46

Dr. McBride is director of behavioral medicine at Floyd Medical Center's Family Practice Residency in Rome, Ga. He is a credentialed pastoral counselor and licensed family therapist. Author disclosure: nothing to disclose.

The quality of the work relationships within your office can make or break every other aspect of your practice. For example, a negative staff caught up in bickering and gossiping is likely to provide poor patient care and service, which in turn can ruin a practice's finances and reputation. On the other hand, a positive, cohesive staff can create an effective and efficient practice where people enjoy coming to work.

Unfortunately, poor work relationships are prevalent in medical practices, and physicians are not always comfortable or prepared to deal with them. Your training and years of practice have helped you to develop and manage quality relationships with patients. Office relationships, however, have their own unique complexities.

It might seem easier to ignore strained work relationships, but it doesn't take long for unaddressed problems to rear their heads and bite. When they do, they can devour your time and energy, and make everyone miserable.

This article describes how to cultivate positive relationships among the employees in your practice.

Building a strong foundation

Achieving positive work relationships can be challenging given the pace and strains of medical office work. Here are some steps you can take to make your office more amenable to positive working relationships.

Establish a sense of community. A strong sense of community can prevent or neutralize a toxic atmosphere.

Developing a sense of community begins with you. As a physician, you shape the identity of the practice and set the pace for how relationships develop. It is up to you to communicate the importance of unity in the office and to help employees feel valued.

To foster these emotions, and thereby build a stronger sense of community, start by hiring employees who are positive and enthusiastic, even if they require more training than an experienced candidate with a negative attitude. You can teach many skills on the job, but attitude is not one of them.

Also, demonstrate through your own behavior how you want employees to act: Be trustworthy, dependable and supportive. Show appreciation for jobs done well and acts of kindness, and stress the importance of listening to and considering each person's ideas.

Encourage open communication. Strong practices engage in open, ongoing communication. They share information with the right people at the right time, and they also make time for meaningful conversation. One way to do this is to have an informal employee discussion over lunch every week or two. This is a great opportunity to update employees on new initiatives and to brainstorm strategies for improving the practice. It's also a great opportunity to celebrate special events in your employees' lives and to share personal stories.

You also might try visiting with each staff member at least once a week. Showing your interest in your co-workers and your concern for them, even if it's just a brief minute of conversation, will let people know they are valued and appreciated, and it can lessen the intensity and stress of the work environment. You can also model effective communication by listening actively, expressing empathy, being receptive to constructive criticism and remaining calm when faced with conflict.

Remember the zone. Each employee in your practice has a comfort zone, or an area where he or she excels. Your practice will be more successful, and your employees will have less tension, if each person's role is suited to his or her special gifts and abilities. For example, the detail-oriented person might not be the best person for greeting patients but might excel at scheduling or filing. Your office should recognize and utilize the strengths of each employee while encouraging staff to explore other areas as well.

Look at the big picture. Dysfunctional work relationships often signal dysfunctional systems. Many offices blame poor relationships on individuals rather than on the system. This is called first-order change (i.e., a change that addresses one part of the system but ignores the system as a whole), which is like treating a patient's symptom without trying to find the cause.

Instead, try to implement a second-order change, which involves changing the system itself. This could involve revising office policies, implementing new processes or making other fundamental changes in the practice.

Ask questions. When an employee seems disgruntled, disruptive or is performing poorly, asking the right questions can help you get to the root of the problem. Consider the following questions before you act:

  • What types of stressors might be affecting this person? Perhaps the employee has recently taken on new responsibilities, or maybe you have a new office manager who is changing policies and “rocking the boat.” Alternatively, the employee might be experiencing stress at home that has nothing to do with work.

  • Is there a pattern of employees in this position having similar problems? Think back to the person who held this position prior to your current employee. There may be problems inherent in the position, such as an unrealistic amount of work or outdated procedures.

  • What processes within the office could be contributing to the problem? Consider whether certain processes could be simplified or made more efficient.

Worth the effort

Paying attention to the relationships within your practice can reap large dividends, while ignoring them can lead to instability or even the collapse of the office community. Don't allow negative feelings to fester. Focus on building positive work relationships that will make your practice a more rewarding and productive place for everyone.

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