Fixing a Dysfunctional Workplace
Stratman says that identifying the issues rather than pointing a finger at individual offenders can be a productive way to frame the discussion. "If you can name the dysfunctions, it becomes less personal and helps people become less defensive," she says.
While many managers think of communication in terms of talking and giving a message, Hertz underscores that listening is vital to uncovering the root problems. "I worked with a cardiology practice, and the first 3 days were like private therapy sessions with the staff. Everybody was so stressed out -- tears and tantrums, emails complaining about each other -- we found that people were spending a lot more time worrying about what other people were doing than they were about themselves."
Establishing clear expectations and desired outcomes can help refocus staff members toward a shared goal, Stratman says. Clarity reduces workplace ambiguity and stress, increases accountability, and promotes teamwork, she says. "People get confused about why they're doing what they do," she says. "They start to think, 'I'm here to serve the doctor,' or 'I'm here to make money,' or 'I'm here because I need a job with flexibility so I can get home at 2:30.' But the reality of it is that you're here to serve the patient. A group becomes a team when it's committed to producing a shared result."
That commitment to serving the patient has to start at the top, Hertz says. While a skilled office manager or administrator can bring all parties to the table, ultimately "physicians have to be responsible for showing leadership," he says.
When Is It Time to Leave the Practice?
Not every relationship is fixable. No one would counsel a friend to stay in an abusive relationship. Similarly, people need to know when it's time to leave a dysfunctional workplace.
"There are really 2 ways to approach this problem," Stratman says. "You buck up, or you punch out. If you can educate yourself about the problem and overcome the initial inertia and start the conversation, you can begin to change the organization. But if you've lost faith in the people you work with and the leadership, then you are inherently going to have trouble working in the system."
Hertz agrees. "If your cultural viewpoint is entirely different from that of the practice, you probably have to leave. But if there is one doctor who is disruptive, there should be a system to address the issue."
Bernstein notes that it can be helpful to talk to colleagues who work in other organizations to gain perspective. Is the problem unique to your office, or do they struggle with similar issues? If so, have they found an effective way to deal with them? Some problems may arise from an individual's perception rather than their reality. "People who are young and naive may come into a medical organization and think it will be like school; that's just not the case."
Other times the problem is real and intractable. "It comes down to your moral compass," Bernstein says. "When you feel you're losing your bearings, when your organization is transcending your own ethics," it's time to get out. "In a medical environment, the primary function should be providing high quality care. You have to look out for the things that absolutely get in the way of that."
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Cite this: Is Your Office Like a Dysfunctional Family? What to Do - Medscape - Sep 11, 2013.