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Turning Tough Talks into Wins

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We've all faced them. The conversations we wish we didn't have to have. Whether with loved ones, team members or superiors, they are all a source of dread. There is little training offered in how to handle these conversations, and most often it is based on past mistakes that hopefully can be learned from. But because handling difficult conversations is one of the keys to success in dental practice, we must find a better way.

Difficult conversations often are called that because usually there is a winner and loser or two losers. In Steven Covey's classic book The Seven Habits of Highly Effective People, probably the most important habit is "win-win." Ideally, we'd like to come out of what we call a difficult conversation with two winners, or at least, with less trauma. Here are a few suggestions on how to achieve that status.

See the other side: They say that really good homicide detectives are successful because they can see the crime through the mind of the murderer. One key to helping smooth out the trauma of a difficult conversation is to first try to see the issue from the other side. What might that team member be thinking when arriving late most days? What will the doctor feel like when the team member asks for a raise? Even if the conversation will be bad news for one party, at least looking at the feelings and results of the message before it's delivered can help ease the reaction.

Rename the event: If you head into a conversation that is already titled "difficult," it's hard to adjust anyone's feeling about it. But if you call it a "challenging" or "growth" conversation, there is a feeling that the experience might be more promising. Often employee reviews might be regarded as difficult conversations. For that reason, a doctor and an employee may skip them. If instead, reviews are retitled "growth conferences," both the doctor and the employee might feel that the purpose is not to list what's wrong, but rather work together to make things better.

Listen: In every conversation, there are two sides. Often the most difficult part of a conversation is to get your side on the table. By looking at the other side, we might realize that listening first to the other person's point of view can help clarify, offer focus on the real problem and diffuse strong feelings. Sometimes difficult conversations are such because they arise in an instant or come up unexpectedly. By taking the time to listen first, you not only get an opportunity to assess the whole issue, but you also give a level of respect to the other person that will allow you both to hear both sides.

Plan ahead: If a difficult conversation is coming in the near future, it can be helpful to rehearse a bit of what may be said and what reactions might be expected. By thinking of possible reactions or responses from the other party to your information, you might be able to plan for palliative responses. It might even help to have alternative results in mind depending on the reaction of the other person. It would be foolish to orchestrate the conversation since you only control one-half of the message, but a bit of rehearsal might allow you to maintain a good comfort level during the conversation and lead to a positive conclusion.

Soften the blow: Some conversations are going to end up in a loss for one of the parties. Preparing for that in advance can help lower the level of frustration or loss of control. In one instance, a dentist knew that the practice was not producing enough to support all of the practice's assistants, so the assistant with the least training faced being laid off. But the dentist proactively set up a conversation with this employee, encouraging him to help move the practice to a higher level that would generate more revenue. That way, there was less surprise and anger when the practice did not reach the goals, and the employee was laid off. In another instance when the dentist had to dismiss an employee, the dentist provided a positive letter of reference to be used in securing another job. It's not always possible, but being generous can soften the blow.

Be sympathetic: By taking the other person's point of view into account and showing a certain amount of compassion in a conversation, at least one person can maintain some control over the process. Often a difficult conversation can generate feelings of anger or lack of control over a situation. Showing that you understand the effect of the message or the position that the person finds himself or herself in can help move the conversation toward a more meaningful conclusion. We've all been at the wrong end of a message and know how defenseless we feel. Acknowledging their feelings and even showing some vulnerability (but not weakness) can often diffuse the potential bad reaction.

Difficult conversations are never easy. They can be a real deterrent to a smooth-running practice if they are overlooked or handled poorly. But they can often be constructive and positive for everyone. From your point of view, staying calm, considering the other person's point of view, listening, offering alternatives and looking for ways to lower the feeling of loss can all help. With practice, handling conversations well becomes automatic because it works.

Dr. van Dyk practices dentistry in San Pablo, California, and teaches in the department of Dental Practice at the Arthur A. Dugoni School of Dentistry at the University of the Pacific. He lectures on a variety of practice management issues. Contact him at bvddds1@gmail.com for more information.